Update: The World Health Organization, WHO, recommends that the monkeypox virus, MPV, be called mpox to reduce stigma. When this guidance was published in July 2022, the association referred to the virus as monkeypox. The guidance has since been updated.
Because of the unique nature of the mpox outbreak, NLGJA: The Association of LGBTQ+ Journalists advises an added layer of caution in how you cover it.
According to the U.S. Centers for Disease Control and Prevention, mpox was discovered in 1958. The first human case was recorded in 1970. The current outbreak in non-endemic countries, including the U.S., Canada, Australia and countries in Europe, began in May 2022.
The mpox virus is spreading primarily among men who have sex with men. This rise in infections comes as LGBTQ+ people experience a rise in anti-LGBTQ+ sentiment nationwide. The LGBTQ+ population already has higher rates of depression and suicide, and careless reporting on mpox can unintentionally stoke fear or suspicion of the community. We advise journalists and newsrooms to keep the following in mind when covering mpox.
Referring to Populations Most Affected by Mpox
Reporting on those being affected by this current outbreak can spark conversations about how to refer to the people most at risk. It is accurate to say that the mpox virus “is currently spreading among men who have sex with men,” which emphasizes a behavior and not an orientation or identity. However, some members of the community object to this usage. They believe it is too clinical, too focused on sex, and doesn’t encompass people who don’t identify as men. “Gay and bisexual men” is another option, but it leaves out those who don’t identify as men or as gay/bisexual.
There are other ways to describe those at risk, such as “men who have sex with men and their sexual networks” or “men who have sex with men, a group that includes people who identify as gay, bisexual, transgender and nonbinary.”
Consider your audience when deciding which terminology to use. If you’re reporting on clinical aspects of the outbreak, “men who have sex with men” may be more appropriate. If you’re reporting on the outbreak’s effects on LGBTQ+ communities, other descriptors may be a better choice.
Use caution when covering vaccination sites:
- We should consider an individual’s medical privacy just as we did during the COVID-19 outbreak. Just because people are in line on a public street or in a public building does not mean they have consented to give up their medical privacy. Ask permission before publishing images that would make a person easily recognizable, avoid taking photos or video of people’s faces or easily identifiable clothing, and consider shooting video/photos in a way that protects an individual’s identity.
- Some people in LGBTQ+ communities may not be out to their friends and family about whom they have sex with. Sharing images of people in these lines may inadvertently expose people to discrimination, ridicule or mental distress.
- Avoid adding to the current heightened level of concern while covering these sites. Many people are scared about the current spread of the mpox virus and may not have spoken to sexual partners about their potential exposure.
Use caution when showing images of mpox pustules/sores:
Because most mpox cases prior to this outbreak were in Central and West Africa, many of the images initially available were of people of color. As that does not reflect the reality of this outbreak, which is affecting people of all races, images of the current outbreak should include pictures of people from a variety of backgrounds and racial/ethnic groups.
LGBTQ+ communities have a long history of fighting the stigma associated with infection and sexual orientation. In the early days of HIV/AIDS, many people expressed outrage at the government’s slow response to the growing crisis. This outbreak has reignited many of those feelings.
The fight against HIV has taught us to be wary of making the following mistakes:
- Mpox is currently spreading among men who have sex with men. However, the CDC and World Health Organization do not define the virus as a sexually transmitted infection. Despite this, it can be spread through sexual contact. Mpox does not discriminate based on gender or sexual orientation. Anyone who has direct contact with a mpox rash or scabs, or with body fluids from a person with monkeypox, is at risk of contracting mpox. Touching objects and fabrics like towels, bedding, or clothing and other surfaces that have come into contact with mpox, as well as contact with respiratory secretions like through kissing, can transmit the virus. The CDC reports that not all infections have occurred through sexual contact. Dancing shirtless at a crowded party or cuddling with clothes on can also be a risk.
- Avoid the term “infected person.” Rather it should be “a person with an infection.” Person-centered language is extremely important when it comes to health stories. Put the person first, not the disease.
- Avoid making stigmatizing statements. If someone tests negative for mpox or has recovered from an infection, do not call them “clean.” Use the correct language: “Bill tested negative for mpox,” or “Bill has recovered from a mpox infection.”
- Anyone can get mpox. Avoid saying that “mpox is spreading in the gay community.” Use more direct language like “The CDC reports that many, though not all, of the reported cases have been among men who have sex with men” or “The CDC reports that mpox is spreading among men who have sex with men.” Men who have sex with men can identify in a number of ways: gay, bisexual, pansexual, nonbinary, transgender, etc.
Be clear on how mpox is spread:
Health officials say some children have contracted the mpox virus. Use caution when reporting these stories so as not to stigmatize gay, bi or trans men and men who have sex with men. Anyone who comes into contact with mpox sores through skin-to-skin contact is at risk of infection.
According to the CDC, mpox spreads in different ways. The virus can spread through:
- direct contact with the infectious rash, scabs or body fluids.
- respiratory secretions during prolonged face-to-face contact, or during intimate physical contact, such as kissing, cuddling or sex.
- touching items, such as clothing or linens, that previously touched the infectious rash or body fluids.
- the placenta of pregnant people to their fetus.
Mpox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks. People who do not have mpox symptoms cannot spread the virus to others. At this time, it is not known whether mpox can spread through semen or vaginal fluids. More information on transmission can be found here.
Be up-to-date on vaccination requirements:
Use care when describing who is eligible to receive the mpox vaccine and ensure information is up to date. Early eligibility guidelines from health departments prioritized sex workers, men who have sex with men who have had more than one anonymous sex partner in the past 14 days, and others who are most at risk, which may factor into some of the stigma people being vaccinated can face. Different health departments are changing their screening guidelines quickly, so the categories from days previous may be outdated and may differ from other communities. As with COVID vaccines, people may misrepresent their exposure in an effort to get earlier access to the vaccine.
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