Where Do We Start with Monkeypox Messaging?

Two doodles on the couch watching the news. The ticker reads, “Anyone can get monkeypox. But in the current outbreak, it’s most common among…”

In the most recent edition of our Health Comm Headlines series, we rounded up some pieces on communicating about monkeypox. Which, it turns out, is pretty complicated! So this week, we’re focusing on what we previously dubbed the million-dollar question, as raised by Jason Mast in STAT: How do you get tools and information about the disease to those who need it without wrongly implying that only that group is at risk, or publicly associating an unfamiliar disease with an already stigmatized community?

This, of course, is in reference to the fact that many cases in this particular outbreak of monkeypox are in men who have sex with men. Some trans women and non-binary folks may be at increased risk as well. (Quick aside: We know that “men who have sex with men” can be problematic, and we’re thinking about how to address it in a future post.) And lots of people are drawing comparisons to the early days of the AIDS crisis, making this an especially fraught communication conundrum. We’ve been doing some pretty serious thinking on this topic — and judging by our inbox, dear readers, so have you!

So we’re bringing you ideas for sharing critical information about monkeypox with the people who need it most — without perpetuating harmful stigma and stereotypes. But before we dive in, we should note that we intend to continue this monkeypox communication convo as the current outbreak evolves — and we’re here for your insights! If you have ideas related to this communication challenge, tweet @CommunicateHlth. Now, for some preliminary thoughts:

Consider leading with the fact that anyone can get monkeypox. This is a slight departure from what we might recommend for a less complicated topic, but consider starting your messaging with a super straightforward statement that anyone can get it. This helps avoid inferences that only some people can get the virus and establishes a non-stigmatizing tone right from the get-go. Then get into the facts about who’s most at risk right now: men who have sex with men. This is a balancing act. Obviously we need to be conscious of stigma, but we also need to get men who have sex with men the info they need to understand their personal risk and how to reduce it — and fast. No doubt this is tricky and potentially a bit uncomfortable, but we don’t want to let perfect be the enemy of good when “good” means getting crucial info to a community that needs it.

Include contextualized info and stats about this outbreak.
Lean on objectively stated facts, and explicitly say they’re the facts we have now (more on that below). Tell your readers that monkeypox is spreading in tight social networks of men who have sex with men, largely through sexual contact. And scientists are trying to understand why this is happening. Use numbers (if they’re available) to help keep things neutral, and avoid any temptation to editorialize the narrative of this outbreak. Fact is, we don’t yet know what that narrative is. Speaking of which…

Clearly state what we don’t know — and what might change. If we could take just one lesson from COVID communication calamities, it’s that we must be transparent about what we know and what we don’t. We’ve talked about how this can help us avoid credibility-damaging U-turns in public health guidance before, but after the last few years it’s taken on health comm scripture status. So be really explicit here: This is what we’re seeing from the data that’s available now. We still don’t know [how easily monkeypox spreads through contact with towels or surfaces, if we’ll see outbreaks at colleges as students head back to their close-contact dorms, or what have you]. Here are the protective steps we recommend based on what we know at this point. You might even consider a “what we know vs. what we don’t” kind of structure for a fact sheet. The more clear we can make it that not everything is clear yet, the better off we’ll all be.

Emphasize the good news about monkeypox. Okay, “good news” in the context of a(nother) global disease outbreak might seem optimistic, but stick with us. Compared to the early days of the COVID and AIDS outbreaks, monkeypox has a couple good things going for it, one of which is an existing vaccine. Of course, you’ll need to be careful with vaccine info due to current supply issues — do your homework and tailor materials in terms of eligibility criteria and geographic location. Aside from the vaccine, we can easily test for monkeypox and experts have identified antivirals that can help treat it. This is all very positive, and thank goodness — people are tired in general, and they’re tired of pandemics. Don’t be afraid to highlight what we’ve got on our side.

Segment segment segment! We know what you’re thinking: Audience segmentation is health comm 101. And that’s true, but we think it’s worth emphasizing. As discussed above, we don’t want to imply things that aren’t true or add to existing stigma about the group most at risk. One way to avoid that messaging murkiness is to tailor — and we mean really tailor — materials to specific audiences. Just think about how different a material that’s only for men who have sex with men would be compared to one for the general public. The former would likely focus on reducing risk through vaccination and other behavioral recs, accessing testing and treatment, and managing painful symptoms — while the latter would be about understanding the evolving situation more generally. Of course, creating multiple materials on a topic has resource implications — but if there was ever a time to push for that out of health comm integrity, surely this is it.

The bottom line: When you’re communicating about monkeypox, avoid perpetuating stigma by stating up front that anyone can get it and then explaining who’s most at risk. After that, stick with tried-and-true health comm best practices. 

Tweet about it: The current #monkeypox outbreak is serving up some serious #HealthComm challenges. @CommunicateHlth shares thoughts on clear messaging sans stigma: https://bit.ly/3JOScg6 #HealthLiteracy


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