Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, United States.
William Allen White School of Journalism and Mass Communications, University of Kansas, Lawrence, KS, United States.
JMIR Public Health Surveill. 2024 Aug 13;10:e59193. doi: 10.2196/59193.
The mpox outbreak resulted in 32,063 cases and 58 deaths in the United States and 95,912 cases worldwide from May 2022 to March 2024 according to the US Centers for Disease Control and Prevention (CDC). Like other disease outbreaks (eg, HIV) with perceived community associations, mpox can create the risk of stigma, exacerbate homophobia, and potentially hinder health care access and social equity. However, the existing literature on mpox has limited representation of the perspective of sexual minority men and gender-diverse (SMMGD) individuals.
To fill this gap, this study aimed to synthesize themes of discussions among SMMGD individuals and listen to SMMGD voices for identifying problems in current public health communication surrounding mpox to improve inclusivity, equity, and justice.
We analyzed mpox-related posts (N=8688) posted between October 2020 and September 2022 by 2326 users who self-identified on Twitter/X as SMMGD and were geolocated in the United States. We applied BERTopic (a topic-modeling technique) on the tweets, validated the machine-generated topics through human labeling and annotations, and conducted content analysis of the tweets in each topic. Geographic analysis was performed on the size of the most prominent topic across US states in relation to the University of California, Los Angeles (UCLA) lesbian, gay, and bisexual (LGB) social climate index.
BERTopic identified 11 topics, which annotators labeled as mpox health activism (n=2590, 29.81%), mpox vaccination (n=2242, 25.81%), and adverse events (n=85, 0.98%); sarcasm, jokes, and emotional expressions (n=1220, 14.04%); COVID-19 and mpox (n=636, 7.32%); government or public health response (n=532, 6.12%); mpox symptoms (n=238, 2.74%); case reports (n=192, 2.21%); puns on the naming of the virus (ie, mpox; n=75, 0.86%); media publicity (n=59, 0.68%); and mpox in children (n=58, 0.67%). Spearman rank correlation indicated significant negative correlation (ρ=-0.322, P=.03) between the topic size of health activism and the UCLA LGB social climate index at the US state level.
Discussions among SMMGD individuals on mpox encompass both utilitarian (eg, vaccine access, case reports, and mpox symptoms) and emotionally charged (ie, promoting awareness, advocating against homophobia, misinformation/disinformation, and health stigma) themes. Mpox health activism is more prevalent in US states with lower LGB social acceptance, suggesting a resilient communicative pattern among SMMGD individuals in the face of public health oppression. Our method for social listening could facilitate future public health efforts, providing a cost-effective way to capture the perspective of impacted populations. This study illuminates SMMGD engagement with the mpox discourse, underscoring the need for more inclusive public health programming. Findings also highlight the social impact of mpox: health stigma. Our findings could inform interventions to optimize the delivery of informational and tangible health resources leveraging computational mixed-method analyses (eg, BERTopic) and big data.
根据美国疾病控制与预防中心（CDC）的数据，从 2022 年 5 月到 2024 年 3 月，美国出现了 32063 例猴痘病例和 58 例死亡病例，全球出现了 95912 例病例。像其他被认为与社区有关的疾病暴发（如 HIV）一样，猴痘可能会造成污名化的风险，加剧恐同情绪，并可能阻碍获得医疗保健和社会公平。然而，现有的猴痘文献对性少数男性和性别多样化（SMMGD）个体的观点代表性有限。
为了填补这一空白，本研究旨在综合 SMMGD 个体的讨论主题，并听取 SMMGD 的意见，以确定当前围绕猴痘的公共卫生传播中存在的问题，从而提高包容性、公平性和公正性。
我们分析了 2020 年 10 月至 2022 年 9 月期间在推特/X 上自我识别为 SMMGD 的 2326 名用户发布的 8688 条与猴痘相关的帖子，这些用户的地理位置在美国。我们在这些推文中应用了 BERTopic（一种主题建模技术），通过人工标记和注释验证机器生成的主题，并对每个主题中的推文进行内容分析。我们对美国各州与加利福尼亚大学洛杉矶分校（UCLA）同性恋、双性恋和双性恋（LGB）社会气候指数相关的最大主题的大小进行了地理分析。
BERTopic 确定了 11 个主题，注释员将其标记为猴痘健康活动（n=2590，29.81%）、猴痘疫苗接种（n=2242，25.81%）和不良事件（n=85，0.98%）；讽刺、笑话和情绪表达（n=1220，14.04%）；COVID-19 和猴痘（n=636，7.32%）；政府或公共卫生反应（n=532，6.12%）；猴痘症状（n=238，2.74%）；病例报告（n=192，2.21%）；病毒命名的双关语（即猴痘；n=75，0.86%）；媒体宣传（n=59，0.68%）；以及儿童猴痘（n=58，0.67%）。Spearman 秩相关表明，在州一级，健康活动主题的大小与美国的 UCLA LGB 社会气候指数呈显著负相关（ρ=-0.322，P=.03）。
SMMGD 个体对猴痘的讨论涵盖了功利主义（例如，疫苗接种、病例报告和猴痘症状）和情绪化（即，提高意识、反对恐同、错误信息/谣言和健康污名）主题。在美国社会对 LGB 接受程度较低的州，猴痘健康活动更为普遍，这表明 SMMGD 个体在面临公共卫生压迫时，存在一种有弹性的沟通模式。我们的社会倾听方法可以促进未来的公共卫生工作，为捕捉受影响人群的观点提供一种具有成本效益的方式。本研究揭示了 SMMGD 对猴痘话语的参与，强调了更具包容性的公共卫生计划的必要性。研究结果还突出了猴痘的社会影响：健康污名。我们的研究结果可以为优化信息和有形健康资源的提供提供信息，利用计算混合方法分析（例如，BERTopic）和大数据。
