PDF(Pubmed)
Abstract：
UNASSIGNED: The 2022-2024 global mpox outbreak, occurring primarily in the sexual networks of gay, bisexual and other men who have sex with men (GBMSM), has not been accompanied by a focus on patient perspectives of illness. We explore the experiences of GBMSM diagnosed with mpox in England to understand needs for social and clinical support.
UNASSIGNED: In-depth interviews (March/July 2023) were conducted with 22 GBMSM diagnosed with mpox in 2022, randomly selected from a national mpox surveillance database, and 4 stakeholders from clinical/community-based organisations. Interviews covered experiences of illness, testing, diagnosis, treatment and contact tracing, and were recorded, transcribed and analysed with a thematic framework.
UNASSIGNED: Media coverage drawing on homophobic stereotypes around sex between men contributed to feelings of stigma and shame. GBMSM living with HIV appeared to cope better with mpox stigma, drawing on their experiences of being diagnosed with HIV for resilience. Younger GBMSM with less experience of stigmatising illness found mpox diagnosis more traumatic and sometimes required support beyond what was provided. Accessing testing could be complicated when healthcare professionals did not recognise mpox symptoms. Men felt information on course of illness, isolation and vaccination after recovery was often inconsistent and contradictory. GBMSM described that care from sexual health and infectious disease units usually better met their emotional and medical needs. This was frequently linked by men to these services having skills in working with the GBMSM community and managing infection risk sensitively. General hospital services and centralised contact tracing could increase feelings and experiences of stigma as some staff were perceived to lack skills in supporting GBMSM and, sometimes, clinical knowledge. Long-term impacts described by men included mental health challenges, urethral/rectal symptoms and life-changing disability.
UNASSIGNED: In this study stigma was a central feature of mpox illness among GBMSM and could be exacerbated or lessened depending on the clinical and social support provided. Involving communities affected by outbreaks in co-producing, planning and delivering care (including contact-tracing) may help improve support provided.
UNASSIGNED: TCW, AJR, AS and FMB received support from the National Institute for Health and Care Research (NIHR) under its Programme Grants for Applied Research Programme (Ref: NIHR202038). CS and JS receive support from the National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with UKHSA; RV receives support from the NIHR HPRU in Emerging and Zoonotic Infections and NIHR HPRU in Gastrointestinal Infections. The views expressed are those of the author(s) and not necessarily those of the NIHR, UK Health Security Agency, World Health Organization or the Department of Health and Social Care.
UNASSIGNED: In-depth interviews (March/July 2023) were conducted with 22 GBMSM diagnosed with mpox in 2022, randomly selected from a national mpox surveillance database, and 4 stakeholders from clinical/community-based organisations. Interviews covered experiences of illness, testing, diagnosis, treatment and contact tracing, and were recorded, transcribed and analysed with a thematic framework.
UNASSIGNED: Media coverage drawing on homophobic stereotypes around sex between men contributed to feelings of stigma and shame. GBMSM living with HIV appeared to cope better with mpox stigma, drawing on their experiences of being diagnosed with HIV for resilience. Younger GBMSM with less experience of stigmatising illness found mpox diagnosis more traumatic and sometimes required support beyond what was provided. Accessing testing could be complicated when healthcare professionals did not recognise mpox symptoms. Men felt information on course of illness, isolation and vaccination after recovery was often inconsistent and contradictory. GBMSM described that care from sexual health and infectious disease units usually better met their emotional and medical needs. This was frequently linked by men to these services having skills in working with the GBMSM community and managing infection risk sensitively. General hospital services and centralised contact tracing could increase feelings and experiences of stigma as some staff were perceived to lack skills in supporting GBMSM and, sometimes, clinical knowledge. Long-term impacts described by men included mental health challenges, urethral/rectal symptoms and life-changing disability.
UNASSIGNED: In this study stigma was a central feature of mpox illness among GBMSM and could be exacerbated or lessened depending on the clinical and social support provided. Involving communities affected by outbreaks in co-producing, planning and delivering care (including contact-tracing) may help improve support provided.
UNASSIGNED: TCW, AJR, AS and FMB received support from the National Institute for Health and Care Research (NIHR) under its Programme Grants for Applied Research Programme (Ref: NIHR202038). CS and JS receive support from the National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with UKHSA; RV receives support from the NIHR HPRU in Emerging and Zoonotic Infections and NIHR HPRU in Gastrointestinal Infections. The views expressed are those of the author(s) and not necessarily those of the NIHR, UK Health Security Agency, World Health Organization or the Department of Health and Social Care.
摘要：
■2022-2024年全球水痘爆发，主要发生在同性恋的性网络中，双性恋和其他与男性发生性关系的男性（GBMSM），并没有伴随着对患者疾病观点的关注。我们探索在英格兰诊断为天花的GBMSM的经验，以了解对社会和临床支持的需求。
■深入访谈（2023年3月/7月）于2022年对22GBMSM诊断为水痘，从国家水痘监测数据库中随机选择，和4个来自临床/社区组织的利益相关者。面试包括疾病的经历，测试,诊断,治疗和接触者追踪，并被记录下来，用专题框架进行转录和分析。
■媒体报道了男性之间对同性恋的刻板印象，导致了污名和羞耻的感觉。携带艾滋病毒的GBMSM似乎可以更好地应对水痘的污名，利用他们被诊断出感染艾滋病毒的经验来提高抵御能力。较年轻的GBMSM对污名化疾病的经验较少，发现痘诊断更具创伤性，有时需要超出所提供的支持。当医疗保健专业人员无法识别出水痘症状时，访问测试可能会很复杂。男人感觉到疾病过程的信息，隔离和康复后的疫苗接种通常不一致和矛盾.GBMSM描述说，性健康和传染病部门的护理通常可以更好地满足他们的情感和医疗需求。男性经常将其与这些服务联系起来，这些服务具有与GBMSM社区合作并敏感地管理感染风险的技能。综合医院服务和集中的接触者追踪可能会增加污名感和经历，因为一些工作人员被认为缺乏支持GBMSM的技能，有时,临床知识。男性描述的长期影响包括心理健康挑战，尿道/直肠症状和改变生活的残疾。
■在这项研究中，污名化是GBMSM中天花疾病的主要特征，根据所提供的临床和社会支持，可能会加剧或减轻。让受疫情影响的社区参与联合生产，规划和提供护理(包括接触者追踪)可能有助于改善提供的支持。
■TCW,AJR,AS和FMB在其应用研究计划计划（Ref：NIHR202038）下获得了国家卫生与护理研究所（NIHR）的支持。CS和JS与UKHSA合作，在UCL的血液传播和性传播感染方面获得美国国立卫生与护理研究所健康保护研究单位（NIHRHPRU）的支持；RV在新兴和人畜共患感染方面获得NIHRHPRU的支持，在胃肠道感染方面获得NIHRHPRU的支持。表达的观点是作者的观点，不一定是NIHR的观点，英国卫生安全局,世界卫生组织或卫生和社会关怀部。
■深入访谈（2023年3月/7月）于2022年对22GBMSM诊断为水痘，从国家水痘监测数据库中随机选择，和4个来自临床/社区组织的利益相关者。面试包括疾病的经历，测试,诊断,治疗和接触者追踪，并被记录下来，用专题框架进行转录和分析。
■媒体报道了男性之间对同性恋的刻板印象，导致了污名和羞耻的感觉。携带艾滋病毒的GBMSM似乎可以更好地应对水痘的污名，利用他们被诊断出感染艾滋病毒的经验来提高抵御能力。较年轻的GBMSM对污名化疾病的经验较少，发现痘诊断更具创伤性，有时需要超出所提供的支持。当医疗保健专业人员无法识别出水痘症状时，访问测试可能会很复杂。男人感觉到疾病过程的信息，隔离和康复后的疫苗接种通常不一致和矛盾.GBMSM描述说，性健康和传染病部门的护理通常可以更好地满足他们的情感和医疗需求。男性经常将其与这些服务联系起来，这些服务具有与GBMSM社区合作并敏感地管理感染风险的技能。综合医院服务和集中的接触者追踪可能会增加污名感和经历，因为一些工作人员被认为缺乏支持GBMSM的技能，有时,临床知识。男性描述的长期影响包括心理健康挑战，尿道/直肠症状和改变生活的残疾。
■在这项研究中，污名化是GBMSM中天花疾病的主要特征，根据所提供的临床和社会支持，可能会加剧或减轻。让受疫情影响的社区参与联合生产，规划和提供护理(包括接触者追踪)可能有助于改善提供的支持。
■TCW,AJR,AS和FMB在其应用研究计划计划（Ref：NIHR202038）下获得了国家卫生与护理研究所（NIHR）的支持。CS和JS与UKHSA合作，在UCL的血液传播和性传播感染方面获得美国国立卫生与护理研究所健康保护研究单位（NIHRHPRU）的支持；RV在新兴和人畜共患感染方面获得NIHRHPRU的支持，在胃肠道感染方面获得NIHRHPRU的支持。表达的观点是作者的观点，不一定是NIHR的观点，英国卫生安全局,世界卫生组织或卫生和社会关怀部。
