Building Trust and Inclusivity: Navigating Layered Stigma and Risk Communication for LGBTQ+ Individuals During COVID-19 Outbreaks

Abstract

Stigmatised groups, including lesbian, gay, bisexual, transgender or queer-identifying (LGBTQ+) individuals, face increased vulnerability to infectious diseases, such as HIV/AIDS, coronavirus disease (COVID-19), and mpox (monkeypox). Layered and intersectional stigma limits healthcare access and public health participation, making trust and inclusivity essential in crisis management and risk communication. This study examines the impact of risk communication on LGBTQ+ communities during the COVID-19 outbreak in South Korea, where detailed personal information shared for contact tracing led to further stigmatisation. Through in-depth interviews (N = 21), the research investigates (1) the intersectional and layered stigma and discrimination LGBTQ+ individuals faced; (2) factors that increased stigmatisation, eroded trust, and discouraged public health engagement, such as COVID-19 testing; and (3) strategies that reduced stigma, fostered inclusivity, and encouraged protective health behaviours. Findings reveal that health authorities' insensitivity, the disclosure of identifiable contact tracing data, and the negative portrayals of LGBTQ+ community spaces collectively exacerbated stigma and public health barriers, particularly in culturally homogeneous and structurally inequitable contexts. Conversely, confidentiality, inclusive messaging, and community-driven support were key to fostering trust and participation. The study underscores the urgent need for crisis management strategies that safeguard marginalised groups' rights, dismantle stigma, and prioritise equitable public health outcomes. These insights offer actionable lessons for policymakers and crisis managers navigating public health emergencies in high-stigma contexts.