Yebela Mpox: gaining a better understanding of perceptions of Mpox

The Yebela Mpox research project (ANRS00908–R–PR) aims to use qualitative methods to understand how Mpox, and in particular its evolution into a sexually transmitted infection, is perceived and understood by populations affected by HIV.

Background to the Yebela Mpox project

Since the resurgence of Mpox (formerly known as ‘monkeypox’) in 2022, the transmission of the virus appears to be evolving. In addition to animal-to-human transmission, sexual transmission of the virus has been observed, including in Central Africa, and appears to be becoming an increasingly significant mode of transmission. This raises new challenges in terms of prevention and public health.

In 2022, sexual transmission played a significant role in the outbreak that spread beyond endemic countries across all World Health Organisation regions. The majority of Mpox cases involved men who have sex with men (MSM), who are often affected by other sexually transmitted infections, including HIV. Furthermore, the Africa CDC has identified that sex workers (SWs) are also at heightened risk of exposure to this virus, as are, in fact, their clients.

Despite this, in Central Africa, knowledge regarding perceptions of Mpox—particularly concerning clade 1b and its human-to-human and sexual transmission—remains limited. Social science studies on Mpox were primarily conducted in Western contexts during the 2022 outbreak, leaving a gap in data on perceptions of this disease in Central Africa.

Objectives of the Yebela Mpox project

Yebela Mpox aims to investigate how a strategy to combat Mpox can be implemented in Central Africa, taking into account both structural factors (availability of healthcare, community mobilisation) and individual factors. The study will focus on key populations for HIV (MSM and sex workers), people living with HIV, healthcare workers and community health workers involved in the Mpox response, as well as the general population living in particularly exposed areas in the Democratic Republic of the Congo, Cameroon and Burundi.

This project draws on social representation theory, which analyses how collective knowledge and beliefs influence the perception of a phenomenon. The aim is to understand how Mpox, and in particular its evolution into a sexually transmitted infection, is perceived and understood by the populations concerned. The study will also examine the circulation of information on Mpox and the organisation of access to care.

To this end, the project will employ qualitative methods (focus groups and individual interviews). Data will also be collected from all facilities providing Mpox services in the study areas using health facility data sheets. This will take place in two areas in each study country, based on epidemiological and strategic criteria relating to the Mpox epidemic. These areas have been defined by the local stakeholders involved in this project and in line with the current situation in each country.

This project will improve knowledge of Mpox management from the perspective of sexual transmission, by highlighting the needs and specific characteristics of under–researched populations in Central Africa. The results obtained will help to adapt prevention and management strategies, taking into account the local social and structural context, and by integrating the essential role of community mobilisation in the response to the epidemic.