Risks of mpox* transmission
Anyone is at risk of mpox* because it can be spread through:
- Close physical contact and shared personal items, such as clothes and bedsheets
- Person-to-person contact, such as contact with skin
- Contact with contaminated surfaces
- Respiratory droplets, such as when a person with mpox* coughs, sneezes, or laughs
Thus, the spread of mpox* is not tied to race, ethnicity, gender, or sexual orientation. However, "due to inconsistent messaging about where the current monkeypox outbreak originated, and the communities most affected by the outbreak, we are confusing an outbreak transmitted through social networks and high community viral load, with sexual behaviors," according to Alanna Bergman, MSN, AGNP-BC, AAHIVS, a PhD candidate at Johns Hopkins University School of Nursing, and coauthors.
Jeffrey Kwong, DNP, MPH, ANP-BC, ACRN, a professor at Rutgers School of Nursing, and colleagues add that some reports in the popular press have described mpox* as a sexually transmitted disease, even though scientists aren’t sure about that yet. "The virus can unquestionably be transmitted during contact associated with sexual encounters. It remains to be seen, however, whether exposure to sexual fluids is the primary mode of transmission."
Mpox* -associated stigma
Still, during the current outbreak in the U.S., most confirmed cases so far have been among men who reported having sex with other men. In addition, people living with HIV are disproportionally likely to develop mpox*. As a result, a person who develops mpox* may face considerable stigma, including multiple types of bias if they have both mpox* and HIV.
Mpox*-associated stigma can make a person too embarrassed to get tested for the disease, seek care, and/or follow the prescribed treatment regimen. Men who have sex with men and people with HIV may face prejudice that blocks them from receiving appropriate preventive care and counseling about mpox*, or prompt diagnosis and treatment.
Nurses can help protect individuals from the effects of stigma by educating other healthcare professionals about stigmatizing behaviors. They also need to be proactive about identifying people at risk of mpox* and suggesting vaccination and other prevention strategies. "Combating stigma begins with nurses being knowledgeable about modes of transmission, sex-positive harm reduction strategies, and general infection control practices," Dr. Kwong and his co-authors note. "Recognizing clinical manifestations of the illness can lead to earlier diagnosis, access to care, and prevention activities."
Read “Monkeypox Virus Outbreak 2022: Key Epidemiologic, Clinical, Diagnostic, and Prevention Considerations“
DOI: 10.1097/JNC.0000000000000365
*In November 2022, the World Health Organization, who is responsible for naming and renaming of diseases under the International Classification of Diseases (ICD), changed the name of the disease referred to as “monkeypox” to “mpox” This change was made to follow current best practices of not naming diseases after animals or geographic locations, and to reduce any stigma that could be associated with the original name. The virus that causes mpox will continue to be referred to as monkeypox virus until the International Committee on the Taxonomy of Viruses (ICTV) officially decides what the name of the virus should be.
