When Stigma, Disclosure, and Access to Care Collide: An Ethical Reflection of Mpox Vaccination Outreach

Author:

Birch Lane1,Bindert Adam1,Macias Susy1,Luo Ellis1,Nwanah Patrick1,Green Noel2,Stamps Jahari3,Crooks Natasha4ORCID,Singer Rebecca M.5,Johnson Robin4,Singer Randi Beth4

Affiliation:

1. College of Nursing, University of Illinois at Chicago, Chicago, IL, USA

2. Department of Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA

3. Southside Health Advocacy Resource Partnership, Chicago, IL, USA

4. Department of Human Development Nursing Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA

5. Department of Population Health Nursing Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA

Abstract

Experiences of stigma in health care encounters among LGBTQ+ populations (lesbian, gay, bisexual, transgender, and queer and questioning) have long been a barrier to care. Marginalization and historically grounded fears of stigmatization have contributed to a reluctance to disclose sexual behavior and/or gender identity to health care providers. We reflect on how student nurses grappled with the ethics of patient disclosure while providing mobile outreach in Chicago for mpox (formerly monkeypox) from fall 2022 to spring 2023. Student nurses addressed how requiring disclosure of sexual behavior or sexual orientation may serve as a barrier to accessing preventive care, such as mpox vaccination. Accounts of stigma and criminalization experienced by LGBTQ+ people provide insight on challenges historically associated with disclosure in health care.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health

Reference39 articles.

1. A Scoping Review of HIV Pre-exposure Prophylaxis Stigma and Implications for Stigma-Reduction Interventions for Men and Transwomen Who Have Sex with Men

2. Centers for Disease Control and Prevention. Mpox: isolation and infection control at home. Updated August 11, 2022. Accessed August 26, 2022. https://www.cdc.gov/poxvirus/mpox/clinicians/infection-control-home.html

3. Monkeypox, stigma and public health

4. Human monkeypox disease (MPX)

5. Centers for Disease Control and Prevention. Mpox: signs and symptoms. Updated December 9, 2022. Accessed December 15, 2022. https://www.cdc.gov/poxvirus/monkeypox/symptoms/index.html

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