Daniel Grace (left) and Mac Stewart
June 27, 2024
By Betty Zou
Amid the usual preparations for Pride events around the world this year, many public health and community agencies also sent out reminders about mpox vaccinations. Here in Toronto, where 21 new cases were reported in the first three months of 2024 (compared to 27 confirmed cases in all of 2023), city public health officials encouraged eligible residents to get vaccinated against mpox.
Mpox, formerly known as monkeypox, is an infectious disease caused by a virus that can lead to painful sores and rashes, among other symptoms. It can affect anyone but during the 2022 mpox outbreak, the vast majority of cases outside of West and Central Africa were among gay, bisexual, queer and other men who have sex with men (GBQM).
Now, two years into the unprecedented global outbreak, a team of researchers led by the Emerging and Pandemic Infections Consortium’s Daniel Grace and Darrell Tan are turning their attention to learnings from mpox in a bid to improve approaches to pandemic preparedness for GBQM communities in Canada.
“The overarching objectives of our interdisciplinary research team are to understand mpox experiences and perspectives of diverse gay, bisexual, queer, and other men who have sex with men across Canada. This work is critical given how gay, bisexual, and queer men have historically experienced significant disparities in physical, mental and sexual health, amplified by systemic marginalization and high barriers to healthcare and were the communities most impacted by mpox in Canada,” says Grace, who is an associate professor at the University of Toronto’s Dalla Lana School of Public Health and director of the Centre for Sexual and Gender Minority Health Research.
The project, which is funded by a Canadian Institutes of Health Research grant, uses a community-based approach to understand the experiences and perspectives of diverse GBQM around topics such as vaccine confidence, health-seeking behaviours and the broader impact of mpox on their social and sexual lives for those who have lived experience of mpox and those who don’t. It also explores the perspectives of health system stakeholders — including doctors and those involved in public health messaging — to learn more about the challenges they faced in responding to, controlling and reducing the impact of the outbreak.
To understand these viewpoints, the researchers have been conducting interviews with health system partners and GBQM across Canada.
Mac Stewart, the project’s research coordinator, notes that because the experience of getting mpox was extremely difficult for many GBQM, the team is very careful in how they approach these interviews.
“We are asking people to come in and talk about what may be the most traumatic thing that’s ever happened to them,” he says. “We have to make sure that they’re fairly compensated and that we’re treating them in a respectful way that makes them feel heard and seen and doesn’t downplay their experience.”
The ultimate goal of the project is to use the findings from these interviews to develop intersectional and stigma-informed approaches to outbreak and pandemic response that are specifically tailored to GBQM communities. This is important because individuals in these communities have historically faced systemic barriers to accessing health care which have led to disparities in physical, mental and sexual health.
To ensure that their work will directly benefit GBQM communities, the researchers are directly engaging with community and public health partners to identify opportunities for knowledge translation.
For Stewart, it all comes down to community.
“A key outcome I think about is how public health can work within communities better to create stronger relationships that are ongoing and not just during a crisis,” he says. One way to achieve this would be to acknowledge, build partnerships with and provide sustained funding to groups on the ground already doing public health-related work.
“Community is the heart and centre of the mpox response. None of this would be possible without people from the community doing the work — that is something we’ve seen over and over again.”
Additional resources:
Mpox: Frequently Asked Questions (Gay Men’s Sexual Health Alliance)