Reducing Stigma in Monkeypox Communication and Community Engagement

How CDC is Framing Communication Around Monkeypox

Helping people make the best-informed decisions to protect their health and the health of their community from monkeypox requires providing key prevention information to the public and working with partners and trusted messengers to ensure information reaches affected communities.

Anyone can get monkeypox, and CDC is carefully monitoring for monkeypox in the United States. CDC is working to provide frontline healthcare providers and public health officials with information about what monkeypox looks like and how to manage the illness. Many—though not all—of the reported cases have been among gay and bisexual men. Given this, CDC is focusing on identifying and using specific channels that will directly reach gay and bisexual men across racial, ethnic, socioeconomic, and geographic backgrounds. In addition to this focused messaging, CDC is also providing information to a wider audience about symptoms and the behaviors that can lead to the spread of monkeypox.

How Partners can Help Message about Monkeypox

  • Partners can help by providing monkeypox information to different communities and various channels. Be careful to avoid marginalizing groups who may be at increased risk for monkeypox. Keep messages fact-based to help prevent stigmatizing populations most affected.
  • While developing resources and messages, use CDC’s Health Equity Guiding Principles for Inclusive Communication.

For Messages to General Audiences:

  • Promote messaging that provides information on what monkeypox is and how it can spread and encourages seeking health care if experiencing monkeypox-like symptoms.
  • Emphasize that anyone can get monkeypox and promote it as a public health concern for all.  Focusing on cases among gay and bisexual men may inadvertently stigmatize this population and create a false sense of safety among those who are not gay and bisexual men.
  • When using images of the rash from patients with monkeypox, focus on how cases typically appear in the current outbreak and avoid showing extreme cases, unless necessary.
    • In some situations, such as healthcare provider education, it may be necessary to show extreme case presentations. Carefully consider the audience and whether only presenting images of how cases typically appear may accomplish the same goals.
  • Include pictures of people from diverse backgrounds and racial/ethnic groups.

For Messages to Gay & Bisexual Men:

  • It’s important to reach any disproportionately affected community with non-alarmist, fact-based messaging about monkeypox that provides people with tools they can use to protect themselves and others.
  • When focusing messages to gay, bisexual, and other men who have sex with men, use targeted channels that directly reach these audiences, such as specific websites, dating apps, or media programs.
  • To help make messages resonate, use relatable or personal stories that depict people “like me” from the intended audience.

Messaging and dissemination tactics may need to be adapted to reach the communities who need the information as we learn more about the current monkeypox outbreak.

How Partners Can Disseminate Messages for Events

CDC encourages partners to reach out to local event organizers to provide information about monkeypox 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.
  • Take an inventory of other venues where close, skin-to-skin contact can occur, such as massage parlors, spas, saunas, and sex clubs.
  • 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.
  • Provide event organizers with 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 in venues
    • A point of contact if they have more questions or need information

It will take partnerships between healthcare providers, affected individuals, and public health officials to ensure people who need care can access it and protect their loved ones.

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.

Describe monkeypox as a legitimate public health issue that is relevant to all people
Educate about monkeypox
Emphasize that:
  • Monkeypox is spread through:
    1. direct contact with an infectious rash, scabs, or body fluids
    2. respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex
    3. touching objects, fabrics (such as clothing or linens) that previously touched the rash or body fluids of someone with monkeypox
    4. being scratched or bitten by an infected animal
  • Monkeypox can be acquired by all people, regardless of gender identity or sexual orientation
  • Monkeypox causes a rash
  • Monkeypox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. This can take several weeks.
Frame the image of monkeypox by
  • Using inclusive language, such as ‘us’ and ‘we’ pronouns
  • Using non-sensationalistic language and images
  • Using language that resonates with the audience
  • Presenting concepts that the audience will be open to hearing or reading
  • Using positive, diverse, and credible images
  • Emphasizing prevention strategies, symptom recognition, and the treatable nature of monkeypox to minimize fear and promote action and sense of personal agency