Negotiating Access to Healthcare and Experience of Stigma Among Cisgender Gay Men Diagnosed with Mpox During the 2022 Epidemic in France: A Qualitative Study.

Abstract

During the global Mpox epidemic of 2022/2023, the first cases in France were identified on 20 May 2022 among gay men. Scientific data on the experience of individuals concerned during the peak of the epidemic in France are scarce. This paper describes the results of the qualitative phase of the French ad hoc ANRS Mpox-SHS study, which was conducted in September/October 2022 among gay men diagnosed with Mpox.Study participants highlighted that they were not surprised at being diagnosed with Mpox, given that they were more exposed to sexually transmitted diseases in general because they had several partners and they were a target group of prevention campaigns.In contrast, the rapidity and extent of the disease's symptoms (pain, rashes, scabs, etc.) surprised many of them. All participants mentioned strong barriers to accessing appropriate care, the most-cited being stigma. Participants felt they were treated like "plague victims". Furthermore, most reported serious social and psychological consequences of being diagnosed with Mpox, arising from their fear that their sexual orientation and/or their sexual practices would be exposed. Moreover, respondents highlighted having an erratic Mpox care pathway, being sent from one health provider to another to receive care. Finally, participants explained that they implemented various negotiation strategies with their healthcare providers, sexual partners, and their employers during their illness.This study highlights the importance of using community health to better understand the development of an epidemic and its impact on affected individuals.