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. 2025:33:101151.
doi: 10.1016/j.jemep.2025.101151. Epub 2025 Jun 27.

Dispositional moral attribution and association avoidance: explaining chronic mpox stigma even after recovery

S Davoudpour  1 , R O Salvador  2 , M G Curtis  3 , A L French  4 , S G Hosek  5 , G Phillips 2nd  1   6 , Pedro A Serrano  1
Affiliations

Dispositional moral attribution and association avoidance: explaining chronic mpox stigma even after recovery

S Davoudpour et al. Ethics Med Public Health. 2025.

Abstract

Background: Prior research indicates that disease-related stigma (e.g., mpox stigma) tends to perpetuate even after the conclusion of the infection. For instance, HIV stigma remains highly prevalent despite the proliferation of stigma-reducing public health initiatives and campaigns. Perpetuation of these stigmas, especially association avoidance well after recovery, has somewhat confounded scholars and public health officials alike. In this study, using the concept of dispositional moral attribution, we offer an explanation for this perpetuated stigma.

Methodology: We developed multiple logistic regression models using data from the mpox substudy of the Keeping it LITE study. This cross-sectional survey was conducted in Illinois, USA in September 2022 and collected the attitudes of 226 sexual minority individuals towards the 2022 mpox outbreak in Illinois.

Results/discussion: Findings indicate a significant positive relationship between moral attribution and association avoidance of those who have recovered from mpox. Individuals who believe those with mpox have participated in immoral activities are 4.5 times as likely to avoid association with those who recovered from mpox compared to those who do not associate mpox with immoral activities.

Conclusion: We conclude that chronic stigmatization, in the form of association avoidance, is more likely when the stigmatized status of an individual is presumed to be the result of their own immoral behavior. Destigmatization campaigns are encouraged to take this finding into account when framing their efforts.

Keywords: Moral Attribution; Mpox; Sexual Minorities; Stigma.

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Conflict of interest statement

Conflict of Interest The authors declare no competing interests. Disclosure of interest The authors declare that they have no known competing financial or personal relationships that could be viewed as influencing the work reported in this paper

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