Is monkeypox an STI? The societal aspects and healthcare implications of a key question

Abstract

This letter explores the societal aspects and healthcare implications that underlie thinking about monkeypox, in the 2022 outbreak, as a sexually transmitted infection (STI). The authors examine what underlies this question, exploring what is an STI, what is sex, and what is the role of stigma in sexual health promotion. The authors argue that, in this specific outbreak, monkeypox is an STI among men who have sex with men (MSM). The authors highlight the need of critically thinking about how to communicate effectively, the role of homophobia and other inequalities, and the importance of the social sciences.

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

“…Although levels of misinformation and stigma in social media posts have decreased since the beginning of the outbreak [56]. a substantial portion of the content still manifests inaccuracies, informational gaps, and elements that contribute to the stigmatization of infected individuals, real risk groups or falsely attributed risk groups [57,58,59,60,61,62,63,64]. Mental health of infected individuals in quarantine during the clinical course or the Mpox disease may be particularly affected by stigma through social media misinformation posts.…”

“…Aroyewun et al [67] argue that the signs and symptoms of Mpox, as well as strategies to control its spread, are linked to stressors such as fear, panic, anxiety, anger, boredom, exhaustion, social isolation, financial loss, and corporeal and social stigma. The exacerbation of these stressors during isolation, fueled by social media posts that promote Mpox-related social stigmatization [56,57,58,59,60,61,62,63,64,68], must not be overlooked. Adler et al [69] highlight that over 25% of hospitalized Mpox patients experience anxiety or depression necessitating counseling.…”

Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: A qualitative study to inform public health guidance and messaging

“…Internationally, the 2022-23 mpox outbreak has almost exclusively affected sexual networks of gay, bisexual or other men who have sex with men (GBMSM) (82.8%) and people living with HIV (PLHIV) (52.5%), with prolonged close or intimate contact with an infected individual the primary route through which infection occurs [12,13]. There are some reports of clusters associated with sexon-premises venues or sex parties, which has prompted debates as to whether mpox should be considered a sexually transmitted infection (STI) [14]. Novel clinical characteristics and transmission -including anogenital and oral mucosal lesions presenting at inoculation sites and mpox DNA detected in seminal fluid [15] -support the potential role of sexual contact as a driver of transmission in the outbreak [13].…”