Stigma and associated factors among Mpox survivors in central Uganda, August 2024–January 2025

Introduction: In January 2025, Kampala Metropolitan Area (KMA) in central Uganda had approximately 60% of the national Mpox burden. In Mpox, like other similar infectious diseases, stigma can persist long after clinical recovery among survivors, leading to social isolation and psychological distress. We determined the prevalence of stigma and associated factors among Mpox survivors in KMA. Methods: We conducted a cross-sectional study in February 2025 among laboratory-confirmed Mpox survivors in KMA, central Uganda. Eligible participants had been treated and discharged from the Mpox treatment unit during August 2024–January 2025. Data on demographics, Mpox-related characteristics, and stigma were collected using interviewer-administered questionnaires, including an Mpox stigma scale adapted from the HIV Berger Stigma Scale. Scores ≥30 were considered indicative of stigma. Modified Poisson regression was used to identify factors associated with stigma. Results: We enrolled 346 Mpox survivors, of whom 197 (57%) were male. The median age was 30 years (IQR, 25-36). Most (66%) were hospitalised for 1–7 days. The prevalence of stigma was 25% (n=87, 95%CI: 21%–30%), with concerns about public attitude (46%) and disclosure concerns (45%) being the most common. Males had a lower prevalence of stigma compared to females (aPR=0.57, 95% CI: 0.39–0.84). Longer hospital stays were associated with increased stigma: 8–14 days (aPR=1.7, 95% CI: 1.1–2.5) and >14 days (aPR=2.5, 95% CI: 1.3–4.5). Among females, being married was associated with lower prevalence of stigma (aPR=0.48, 95% CI: 0.26–0.87). Among males, hospitalisation for >14 days (aPR=2.9, 95% CI: 1.3–6.5) was associated with increased prevalence of stigma. Conclusion: Approximately one in four Mpox survivors experienced stigma, with a higher prevalence among females and those with prolonged hospitalisations. Marriage was protective among females, whereas prolonged hospitalisation was a key driver among males. The most common concerns were about disclosure and the public’s attitude towards Mpox. Efforts to reduce stigma could prioritize public education and provision of psychosocial support, especially for survivors with extended hospital stays. Gender-sensitive programs may address the unique stigma experiences of different sexes. Keywords: Stigma, Mpox, Survivors, Disease outbreaks, Uganda