Mpox stigma among men who have sex with men in the Netherlands: Underlying beliefs and comparisons across other commonly stigmatized infections

Abstract

People with or at risk for mpox are likely to be stigmatized because of analogies to other sexually transmitted infections. Stigma is driven by beliefs about the perceived severity of the condition and perceived responsibility for acquiring the condition, both in broader society and individual responsibility. We explored these beliefs and compared them across mpox, human immunodeficiency virus (HIV), syphilis, gonorrhoea, and chlamydia in an online survey, conducted in July 2022, with 394 men‐who‐have‐sex‐with‐men in the Netherlands. We compared mean scores between infections using repeated measures analysis of variance and conducted hierarchical regression analyses to identify determinants of both mpox perceived responsibility endpoints. Results showed that participants expected that mpox would be seen as a “gay disease” and will be used to blame gay men. Compared to other infections, mpox was considered less severe than HIV, but more severe than syphilis, gonorrhoea, and chlamydia. Perceived responsibility was comparable across infections, but, for each infection, participants perceived attributed responsibility to be higher in society than individual responsibility. Both perceived responsibility endpoints were highly correlated with each other and with other stigma beliefs. These results provide insight on the underlying determinants of mpox stigma and demonstrate that anticipated mpox stigma is present in the Netherlands.

Using a theoretical framework of Intervention Mapping to inform public health communication messages designed to increase vaccination uptake; the example of mpox in the Netherlands

“…framing as ‘gay disease’). The available literature shows that various types of stigma represent a major barrier to health-seeking behaviour [ 22 ]. Stigma has been associated with the actual experience of and the fear of discrimination and negative societal attitudes because of a particular condition [ 22 ].…”

“…The available literature shows that various types of stigma represent a major barrier to health-seeking behaviour [ 22 ]. Stigma has been associated with the actual experience of and the fear of discrimination and negative societal attitudes because of a particular condition [ 22 ]. Compared to the general population, marginalized groups, including GbMSM/TGP, are often subjected to higher levels of stigma [ 23 ].…”

Characterizing Indicators of Engagement in HIV-Associated Healthcare and Clinical Outcomes among People with HIV and Mpox in Washington, DC: A Nested Case-Control Study of the DC Cohort

“…As with HIV, the underlying stigma associated with mpox must be addressed. Stereotypical beliefs around populations most impacted by the outbreak, such as MSM, may inhibit engaging in clinical care and lead to further misclassification [ 22 , 23 ]. Messaging around mpox vaccination can go hand in hand with reducing stigma by normalizing preventative measures.…”

Public Health Strategies Against Social Stigma in the Mpox Outbreak: A Systematic Review

“…Schmidt-Sane et al [36] and Lim et al [33] accentuate the indispensability of contact networks in diffusing accurate information within vulnerable populations. Critically, investigations into the general population and key groups regarding their comprehension of the disease, perceptions of discriminatory reactions, socially stigmatizing responses, and instances of informational disarray [49,50,51,52] become imperative to adjust the discourse, target audience, and content of public health information campaigns to prevent or mitigate the social stigma attributed to Mpox-infected individuals and socially discriminated groups.…”