“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

Background
The Mpox epidemic disproportionately impacted Black and Latino sexual minority men (BLSMM) in the United States, with them having the highest prevalence of disease and the lowest rates of vaccination. Despite this disparity, BLSMM perspectives on the disease, Mpox-related stigma, and inequitable rollout of and distrust in the Mpox vaccine are absent from the literature. The present study aims to describe experiences with Mpox-related sexual behaviors, stigma, and vaccine barriers and facilitators among a sample of BLSMM living in both California and New York.

Methods
In this qualitative interpretive phenomenological study, we utilized semi-structured individual interviews as the primary source for data collection. Data was collected between August 2021 and December 2022 from 41 adult participants in California and New York. Interviews were recorded, transcribed verbatim, and analyzed using thematic content analysis.

Results
Participants ranged in age from 19 to 65 years, with the majority identifying as Black (73%) and male gender (93%). Overall, participants’ narratives revealed that initial messaging around Mpox produced stigma parallel to the HIV/AIDS pandemic with many participants curtailing their sexual behaviors as a harm reduction strategy. Mpox-related stigma negatively impacted sexual minority communities both internally and externally. Participants’ narratives also revealed general vaccine skepticism due to existing medical distrust, negative vaccine experiences by other BLSMM, and lack of prioritization of outreach and distribution efforts in communities of color.

Conclusion
Alterations to vaccine administration protocols and outreach efforts for reasons identified in this study are critical to addressing disparities in vaccine uptake among BLSMM. Public health practitioners must consider equitable frameworks, existing stigmas, and medical distrust when engaging BLSMM.