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当污名化、披露和获得医疗服务发生冲突时:对猴痘疫苗接种外展的伦理反思。

When Stigma, Disclosure, and Access to Care Collide: An Ethical Reflection of mpox Vaccination Outreach.

机构信息

College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.

Department of Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.

出版信息

Public Health Rep. 2024 May-Jun;139(3):379-384. doi: 10.1177/00333549231201617. Epub 2023 Oct 16.


DOI:10.1177/00333549231201617
PMID:37846098
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11037228/
Abstract

Experiences of stigma in health care encounters among LGBTQ+ populations (lesbian, gay, bisexual, transgender, and queer and questioning) have long been a barrier to care. Marginalization and historically grounded fears of stigmatization have contributed to a reluctance to disclose sexual behavior and/or gender identity to health care providers. We reflect on how student nurses grappled with the ethics of patient disclosure while providing mobile outreach in Chicago for mpox (formerly monkeypox) from fall 2022 to spring 2023. Student nurses addressed how requiring disclosure of sexual behavior or sexual orientation may serve as a barrier to accessing preventive care, such as mpox vaccination. Accounts of stigma and criminalization experienced by LGBTQ+ people provide insight on challenges historically associated with disclosure in health care.

摘要

在医疗保健中,LGBTQ+(女同性恋、男同性恋、双性恋、跨性别和酷儿)群体经历的污名化问题一直是获得医疗服务的障碍。边缘化和历史上对污名化的恐惧导致人们不愿意向医疗保健提供者透露性行为和/或性别认同。我们反思了学生护士在 2022 年秋季至 2023 年春季期间在芝加哥为 mpox(以前称为猴痘)提供移动外展服务时,如何处理向患者披露信息的伦理问题。学生护士们讨论了要求披露性行为或性取向可能会成为获得预防保健(如 mpox 疫苗接种)的障碍。LGBTQ+人群经历的污名化和刑事定罪的描述提供了对历史上与医疗保健披露相关的挑战的洞察。

相似文献

[1]
When Stigma, Disclosure, and Access to Care Collide: An Ethical Reflection of mpox Vaccination Outreach.

Public Health Rep. 2024

[2]
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[3]
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[4]
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[5]
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[6]
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[8]
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[9]
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引用本文的文献

[1]
Harnessing community-based one health interventions implementation beyond Mpox outbreak management in Africa: insights and benefits.

Infect Dis Poverty. 2025-9-8

[2]
Combining mpox vaccination and behavioural changes to control possible future mpox resurgence among men who have sex with men: a mathematical modelling study.

BMJ Public Health. 2025-7-31

[3]
Strategies and Opportunities to Improve Community Health through Advanced Molecular Detection and Genomic Surveillance of Infectious Diseases.

Emerg Infect Dis. 2025-5

[4]
"I Know They're Going to Weaponize This:" Black and Latino Sexual Minority Men's Mpox-Related Sexual Behaviors, Stigma Concerns, and Vaccination Barriers and Facilitators.

J Racial Ethn Health Disparities. 2025-4-4

[5]
Psychosocial impact and stigma on men who have sex with men due to monkeypox.

Front Public Health. 2025-3-19

[6]
Health Behaviors and Experiences of LGBTQ + Individuals during 2022 Mpox Outbreak: Findings from the QVax Study.

J Community Health. 2025-2

本文引用的文献

[1]
Mpox vaccination willingness, determinants, and communication needs in gay, bisexual, and other men who have sex with men, in the context of limited vaccine availability in the Netherlands (Dutch Mpox-survey).

Front Public Health. 2022

[2]
Monkeypox, stigma and public health.

Lancet Reg Health Eur. 2022-10-31

[3]
Human monkeypox disease (MPX).

Infez Med. 2022-9-1

[4]
Associations between HIV testing and multilevel stigmas among gay men and other men who have sex with men in nine urban centers across the United States.

BMC Health Serv Res. 2022-9-20

[5]
The Role of Contextual Factors in the Health Care Utilization of Aging LGBT Adults.

Gerontologist. 2023-5-9

[6]
How can the nursing profession help reduce sexual and gender minority related health disparities: Recommendations from the National Nursing LGBTQ Health Summit.

Nurs Outlook. 2022

[7]
The impact of sources of stigma on health care avoidance among gay and bisexual men in Australia.

AIDS Care. 2023-5

[8]
Cumulative minority stress and suicide risk among LGBTQ youth.

Am J Community Psychol. 2022-3

[9]
HIV-Related Stigma Research as a Priority at the National Institutes of Health.

AIDS Behav. 2022-1

[10]
Ending unjust HIV criminalization: leave no-one behind.

J Int AIDS Soc. 2021-2

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