Mpox Equity and Anti-Stigma Toolkit

Health and Vaccine Equity

CDC is committed to health equity, which means everyone has fair and just opportunity to their highest level of health. For mpox, this includes reliable access to accurate information and prevention education, as well as vaccine access. It is important that communities most affected by mpox have access to timely, clear, and appropriate information, and a safe and effective mpox vaccine to prevent future outbreaks. In the 2022 mpox outbreak, gay, bisexual, and other men who have sex with men (MSM) make up most of the cases.  Within this population, mpox cases are disproportionately higher among Black and Hispanic or Latino MSM and, in smaller numbers, Black and Hispanic or Latina women. Gender minorities, including transgender women and non-binary people, have also been disproportionately affected by mpox.

Many social, geographic, political, economic, and environmental factors create challenges to health equity and vaccination access. Some of these factors include:

• Literacy, education, income, and wealth gaps
• Job access and working conditions
• Racism, homophobia, transphobia, and other forms of misinformation and discrimination
• Gaps in healthcare access
• Transportation and neighborhood conditions
• Lack of trust because of past medical racism and experimentation
• Perceived or actual stigma when accessing medical care

Equity-focused outreach and vaccine projects present an opportunity to reach populations who are most affected by mpox but are less likely to be vaccinated. These projects may reach populations who face barriers to vaccination such as language differences, inability to access vaccination sites, lack of transportation, lack of paid time off, low vaccine confidence, mistrust of government, lack of access to online scheduling technology, and fear of stigma.

The U.S. government is working with state, tribal, local, and territorial public health departments and other community partners to distribute vaccines where they are needed most.

How Partner Organizations Can Disseminate Messages for Events

CDC encourages partners to reach out to local event organizers to provide information about mpox and offer information and messages to share. The following are some tips:

• Conduct an environmental scan of upcoming, large-scale events in your community. Consider festivals where there may be spin-off or side events like dances and gatherings where people may have close, skin-to-skin contact with others.
• Develop partnerships with sex-on-premises/commercial sex venues (sex clubs, bath houses, or businesses with back rooms) to disseminate clear messages to staff and patrons in spaces where communities meet for social and sexual engagement.
• Engage trusted community-based organizations, community leaders, and community healthcare providers to connect with event organizers and impacted communities.
• Have a clear call to action. This can include raising awareness by sharing information, asking people to seek health care if they experience a rash, or directing community members to local healthcare providers who can coordinate testing or vaccination.
• Provide event organizers with culturally and linguistically appropriate information and materials such as:
  • Messages that can be used on websites and social media sites
  • Talking points that event organizers can use when talking with their customers or attendees
  • An event organizer letter template (available as Word [32 KB, 2 pages] or PDF [1 MB, 2 pages] files), which organizers can download, adapt, and send to their attendees/customers
  • Printed materials that can be passed out at events and posted in venues
  • A point of contact, if they have more questions or need information

Stigma Reduction Communication Strategies

The following table has been adapted from Hood & Friedman (2010), Unveiling the hidden epidemic: a review of stigma associated with sexually transmissible infections. Sexual Health (7):1-12.