4 - (SYM 16) Mpox and the Mental Health of Sexual Minority Men in the US: Examining Associations Between Epidemic-related Cognition and Symptoms of Anxiety and Depression

Sexual minority men (SMM) accounted for most infections in the recent mpox (formerly “monkeypox”) outbreak in the US. Decades of HIV research documented the psychological burden associated with infectious disease risk. Belief one may contract HIV and the anticipated consequences of infection are established correlates of anxiety and depression. This study evaluates associations between 3 domains of mpox-related cognition—risk perception, optimistic bias, and collective self-efficacy—and mental health outcomes among SMM. Between July 28 and September 22, 2022, 2,620 adult cisgender SMM (no previous mpox diagnosis) responded to recruitment advertisements on social networking applications and completed an online survey. Participants completed the Patient Health Questionnaire – 4 (PHQ-4; a brief indicator of anxiety and depression) and adapted measures of mpox risk perception, concern, optimistic bias, and collective self-efficacy. They also reported mpox vaccination status, relationship status and quality, recent (past 30 day) substance use and sexual behavior, as well as demographic characteristics. Results of a linear regression predicting PHQ-4 scores found mpox concern positively associated with PHQ-4 scores (β = .11, p < .001); meanwhile, collective self-efficacy was negatively associated with PHQ-4 scores (β = -.05, p =.007). There was evidence of a significant quadratic effect for optimistic bias (β = .05, p =.03). At average levels, optimistic bias was negatively associated with PHQ-4 scores (β = -.08, p < .001). This effect was amplified as optimistic bias decreased and diminished as it increased. Above the mean response, the association between optimistic bias and PHQ-4 scores was non-significant. Findings underscore the potential mental health costs associated with infectious diseases—and potential community-level factors which may provide resilience to individuals. Results suggest the potential utility of routine mental health screening at mpox vaccination sites to identify SMM in need of intervention. They also suggest that community-level interventions that emphasize collective action to mitigate mpox could yield mental health benefits.