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• Posted January 18, 2024

Many Closeted Gay Men Didn't Receive Mpox Care During Outbreak

Too many closeted gay and bisexual men didn't receive treatment for infectious mpox during the recent global outbreak, a new report finds.

It wasn't necessarily because they feared being outed if they sought care, experts said. Instead, these men's separation from the wider LGBT community may have meant they had less information on treatments.

"I think the lesson here is that there are things to be gained by enmeshing yourself in your community, if you can,"said study lead author Joel Le Forestier. He's a postdoctoral researcher in communication at Cornell University in Ithaca, N.Y.

"Affiliating with that community and becoming a part of that community can confer some real benefits to you," Le Forestier explained. "Knowing about public health resources is not the only thing, but it's definitely one of them."

The new findings were published Jan. 12 in the journal Psychological Science.

In the study, Le Forestier and colleagues had gay, bisexual and sexual minority men in Australia, Britain, Canada and the United States fill out online questionnaires. The questionnaires were completed at two time points: during the August 2022 peak of the mpox outbreak (864 respondents) and two months later (685 respondents).

Le Forestier said he and his team initially assumed that being closeted might be the factor keeping some men from mpox treatment.

That stemmed from something he observed while pursuing doctoral work in Toronto. He noticed that locals waiting in a long line for the mpox vaccine were overwhelmingly out, self-identified gay and bisexual men.

"I'm thinking, if you're in this long line of identifiably sexual minority men, and your friend walks by, you've just been outed to your friend," Le Forestier said in a Cornell news release.

But a friend of Le Forestier's had a different theory.

"He said, 'It might not just be that they would be too afraid to get in that line because they worry about being outed; it might be that they don't know that line even exists,'"Le Forestier said.

"The only places that my friend had seen ads for mpox vaccine clinics were in gay bars, and in the local gay village community center," he said. "So, if you're not engaging in the community in these sort of public ways, then these resources just aren't getting to you."

The study results seemed to support that theory.

"People who conceal their sexual orientations reported what we thought they would: concerns that if they sought out mpox resources, that would 'out' them and that would be bad,"Le Forestier said. "But we also predicted that having those concerns would be related to a lower likelihood of them accessing those resources -- they'd be concerned about that and they wouldn't go to the clinic -- but that's not what we found."

In the end, the study found that if men knew that mpox treatments were available, they tended to seek them out, regardless of whether they were out or not.

"What that suggests,"Le Forestier said, "is that people who are in the closet and afraid of being outed are nonetheless saying, 'This is important enough to me that I'm going to do it anyway.'"

So, how to get info on mpox prevention and treatment to at-risk folks who are not deeply involved in the LGBT community is a "million-dollar question," La Forestier said.

"The resource knowledge and community-connected piece seems to be implicated in that process, not outing concerns, and that was a surprise to me,"he said.

More information

There's more on mpox and its prevention and care at the U.S. Centers for Disease Control and Prevention.

SOURCE: Cornell University, news release, Jan. 16, 2024