What Makes a Sexually Transmitted Infection? Discrepant Frames in United States Mpox Discourse and Public Health Response

In 2022, an mpox outbreak spread around the world, impacting over 100 countries and prompting scientists, clinicians, activists and public health experts to investigate how the virus was spreading and among whom. Initial transmission was traced to gay male social events involving sexual activity, raising questions and controversies about the nature of the virus. Drawing on media coverage, public health messaging and biomedical research from the 2022 outbreak, as well as my own involvement in the NYC mpox response, I find that the collective response to the epidemic was configured by two central, competing frames: (1) mpox as an STI and a gay disease, and (2) mpox as neither an STI nor a gay disease. By tracing how the same set of developments led to such divergent constructions, I argue that mpox classification has been largely driven by sexual politics, rather than only biomedical evidence. Furthermore, the outbreak exemplified how the public health enterprise has not reconciled its capacity to produce stigma with its mission to ensure population health, which weakened U.S. response. This paper extends sociology research on sexual health by demonstrating how the subcategory of STI is itself a site of contestation and how the unresolved politics of the STI category directly impacts emerging infectious agent response.