Monkeypox-Related Stigma and Vaccine Challenges as a Barrier to HIV Pre-Exposure Prophylaxis among Black Sexual Minority Men

Rodman E Turpin; C J Mandell; Aaron D Camp; Rochelle R Davidson Mhonde; Typhanye V Dyer; Kenneth H Mayer; Hongjie Liu; Thomas Coates; Bradley O Boekeloo

doi:10.3390/ijerph20146324

Monkeypox-Related Stigma and Vaccine Challenges as a Barrier to HIV Pre-Exposure Prophylaxis among Black Sexual Minority Men

Int J Environ Res Public Health. 2023 Jul 8;20(14):6324. doi: 10.3390/ijerph20146324.

Authors

Rodman E Turpin¹, C J Mandell¹, Aaron D Camp^{2

3}, Rochelle R Davidson Mhonde¹, Typhanye V Dyer⁴, Kenneth H Mayer^{5

6

7}, Hongjie Liu⁴, Thomas Coates⁸, Bradley O Boekeloo⁹

Affiliations

¹ Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA 22030, USA.
² Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA.
³ INOVA Health System, Fairfax, VA 22031, USA.
⁴ Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA.
⁵ The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
⁶ Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
⁷ Harvard Medical School, Harvard University, Boston, MA 01451, USA.
⁸ David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
⁹ Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA.

Abstract

Background: The U.S. monkeypox (mpox) outbreak of 2022 was a unique emergent public health crisis disproportionately affecting Black sexual minority men (BSMM). Similar to other stigmas, mpox-related stigma may have adverse effects on BSMM, including deterring HIV prevention such as PrEP.

Methods: Our study investigated the experiences and perceptions of BSMM related to mpox, including mpox-associated stigma, and PrEP engagement among BSMM. We conducted qualitative interviews of 24 BSMM attending HIV prevention-related events in the greater D.C. Metropolitan area. In-depth interviews were conducted via phone, and responses to questions specific to the mpox outbreak were analyzed using thematic analysis.

Results: We identified three key themes from the analysis: Mpox-related stigma, Mpox vaccine availability concerns, and Mpox vaccine hesitancy. Participants also described relationships between each of these three themes and PrEP use. Mpox stigma was particularly relevant as it is related to sexual stigma and is a deterrent to PrEP use. A sense of health system neglect of BSMM, especially related to low mpox vaccine availability, was also described.

Conclusions: We identified mpox stigma and challenges related to mpox vaccination as key themes among BSMM, with implications for PrEP use. Future research exploring medical mistrust among BSMM, particularly related to HIV prevention, is recommended.

Keywords: HIV; PrEP; intersectionality; mpox; race; sexuality.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Anti-HIV Agents* / therapeutic use
HIV Infections* / drug therapy
HIV Infections* / prevention & control
Homosexuality, Male
Humans
Male
Mpox (monkeypox)* / drug therapy
Pre-Exposure Prophylaxis*
Sexual and Gender Minorities*
Smallpox Vaccine* / therapeutic use
Social Stigma
Trust

Substances

Smallpox Vaccine
Anti-HIV Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding