“ Another gay fear ”: community reflections on UK public health responses to the 2022 mpox outbreak

Abstract Background Between May and December 2022, the UK Health Security Agency reported 3,585 cases of mpox. The 2022 global outbreak was characterised by transmission predominantly within sexual networks of gay and bisexual men (GBMSM). UK public health responses included information and vaccination campaigns, supported by behaviour change among GBMSM. We describe community reflections on the UK mpox outbreak and the responses to it. Methods Between August 2023 and April 2024, we conducted five focus groups with participants (n=27) recruited through community organisations in London and Manchester. Participants were predominantly gay men from ethnically diverse backgrounds. Data were analysed thematically. Results Coming soon after COVID-19, the mpox outbreak intensified fears of returning to lockdown. Reports of GBMSM being most affected, and its framing in the media as a ‘gay disease’, coupled with warnings within GBMSM networks echoed earlier experiences of HIV. Those who had acquired mpox reported that media coverage had intensified their experiences of stigma and discrimination. Participants perceived vaccine roll out as inequitable; Furthermore, the perceived sudden cessation of public health messaging and advice left participants uncertain about ongoing risk and the need for prevention. Conclusions Participant reflections two years after the 2022 mpox outbreak demonstrate how previous pandemics shape emotional responses to new outbreaks. Key challenges included stigmatising media coverage, inequitable vaccine rollout, and sudden discontinuation of public health messaging. These findings highlight the importance of targeted, non-stigmatising and unambiguous communication from trusted sources during and after an outbreak. What is already known on this topic The media response to the 2022 UK mpox outbreak led to stigma among GBMSM and public health measures were not equitably accessible What this study adds People from communities affected by the outbreak sought timely information from trusted sources. Communication needs do not end with outbreaks How this study might affect research, practice or policy There is a need for ongoing public health work to build trusted networks who can maintain inter-outbreak communications and respond rapidly to outbreaks