Empowering mpox prevention through agency: risk and control mechanisms in gay and bisexual men

Despite the decline in cases, the ongoing mpox outbreak that started in 2022 remains a public health concern. Due to its disproportionately high risk on gay, bisexual, and other men who have sex with men, there is an urgent need to develop tailored, culturally sensitive health messaging for these marginalized populations. Drawing on agency assignment and locus of control (LOC) research, this study examined the effectiveness of agency assignment using infographics in communicating risk and control to gay and bisexual men, empowering them to take protective actions. An online experiment (N = 402) with a 2 (agency of transmission: human vs. virus) by 2 (agency of protection: human vs. external) design showed that assigning visual-textual agencies to distinct entities influenced corresponding agency perceptions. Perceived human transmission agency predicted higher perceived ingroup risk, while perceived human protection agency predicted higher internal LOC and lower external LOC. These risk and LOC perceptions were positively linked to self-protection and community support intentions. The findings extend the literature on health risk messaging for marginalized communities through the agency assignment perspective and suggest the need for practitioners to highlight human agency and address systemic barriers in risk prevention.