"The new gay plague": qualitative analysis of public attitudes toward monkeypox

Monkeypox was declared a public health emergency on August 4, 2022, in the United States. The emerging isolation of the virus in the LGBTQ+ community--particularly among gay, bisexual, and men who have sex with men (GBMSM)--has led many to draw parallels between the emerging multi-country outbreak and the 1980s HIV/AIDS crisis. The purpose of this study was to investigate media framing of the monkeypox outbreak in American media through the lens of HIV social constructionist theory. Content analysis of a sample of 59 articles from the top-five most viewed U.S. media outlets was collated against quantitative trends in word frequencies in monkeypox-related tweets (n = 255,363). Results found that coverage often framed monkeypox as a product of GBMSM hypersexuality, leading to potentially stigmatizing perceptions and the drastic increase in tweet content related to sexual activity. While greater attention to stigma was observed in coverage, blame attribution to populations, governments, and practices was one of the most common frames across all media sources. Heavy reporting of systemic barriers to vaccination, testing, or diagnosis serve as continuities from HIV/AIDS and COVID-19 epidemics, underscoring fears around a second plague and influencing public attitudes. Monkeypox conspiracy theories also proliferated heavily on Twitter, with a noticeable increase in conspiracy language over time. These findings can inform the social realities of monkeypox, an understudied dimension, of which an understanding is vital to implementing services that address all elements of the ongoing outbreak.