Background
Stigma has emerged as a prominent public health challenge in the 2022–2024 global mpox outbreak, impeding outbreak control efforts and the well-being of affected individuals. Addressing stigma is a priority for improving infection prevention and control. Despite its frequent mention in public and policy discourse, robust assessment of mpox stigma is lacking. This study investigated the causes, manifestations, and public health impacts of mpox-related stigma in the United Kingdom (UK).
Methods
We conducted an online, mixed-methods cross-sectional survey to assess mpox stigma. We developed and content validated a new tool, the Stigma Survey and Community-based Assessment for New and Re-emerging outbreaks (Stigma-SCANR) for this purpose. Through quota sampling, the survey targeted populations most affected by mpox at the time of data collection (March–July 2024), including gay, bisexual, and other men who have sex with men (GBMSM), and healthcare workers.
Results
437 respondents were included. Pre-existing prejudices toward groups linked with mpox, such as GBMSM and migrants, were identified as drivers of stigma, alongside fear and misinformation. Most respondents anticipated mpox-related social stigma from a few to half of their community, and more commonly from the public rather than their own social circle. Among the 13 respondents who reported a previous mpox diagnosis, 11 (85%) had experienced mpox-related stigma. Nearly a quarter of respondents (24%) said they would not, or were unlikely to, tell a recent sexual partner about an mpox diagnosis. Feelings of shame were considered the most common barrier to care-seeking (299 respondents, 68%).
Conclusion
This analysis of mpox stigma in the UK offers insights for the current international outbreak response, particularly in countries with similarly affected communities. Lessons learnt may also be transferable to other disease outbreaks. We propose a range of practical recommendations for reducing stigma in future outbreaks, including peer support initiatives, distributing accessible information about safe timelines for returning to socialising and work or school, and co-designing public health communications and contact tracing programmes with affected community members.