Table 1.

Guiding principles to address stigma in pandemic preparedness and pandemic responses with case examples from HIV, COVID‐19 and mpox

Guiding principle	Question examples for a stigma‐informed response	Case example: HIV	Case example: COVID‐19	Case example: Mpox
Examine underlying stigma drivers and facilitators	Drivers: What prejudice, stereotypes and judgement do affected communities experience? Facilitators: What are current: social inequities, occupational health and safety standards, and legal contexts for affected populations? What are relevant health policies and healthcare access?	Drivers: — prejudice, stereotypes and judgement experienced by affected communities (e.g. sex workers and men who have sex with men [MSM]) Facilitators:— criminalization (e.g. of sex work, LGBTQ persons, HIV non‐disclosure) — ethno‐racial, MSM and socio‐economic disparities in HIV	Drivers:— prejudice, stereotypes and judgement of Asian communities — social value of groups impacted by COVID‐19 Facilitators: — criminalization of public health responses — policies for accessing vaccines, testing and sick leave — occupational safety standards	Drivers: — prejudice, stereotypes and judgement experienced by MSM — community awareness of mpox Facilitators:—health policies regarding mpox testing, vaccination and treatment — health policies for sick leave and medical care access — ethno‐racial and MSM healthcare disparities
Assess peril, visibility and controllability	Peril: How dangerous is the infection considered? Visibility: Is this a visible or a concealable condition? Controllability: How responsible are persons perceived for acquiring the infection?	Peril: — extent of HIV treatment literacy Visibility:—signs of health conditions linked with HIV (e.g. Kaposi sarcoma) Controllability: — blame of key populations for HIV acquisition and transmission	Peril: — mortality and perceived severity of COVID‐19 Visibility: — visible Asian ethno‐racial minority persons targeted by anti‐Asian racism Controllability: — blame for becoming infected with COVID‐19	Peril: — severity of illness with mpox Visibility: — visibility of lesions and illness Controllability: — blame of persons with mpox, including MSM, for their infection
Identify community strengths	What social histories of solidarity, mutual support and collective care exist among affected communities? What community strengths can be leveraged in pandemic responses?	— LGBTQ community‐groups and AIDS service organizations that support affected communities — histories of HIV activism and mutual support	— mutual support or poverty alleviation networks for people who miss or lose employment due to COVID‐19 infection, quarantine and/or lockdowns — anti‐racist solidarity movements	— LGBTQ community‐groups and AIDS service organizations to support affected communities — community care networks to help persons access and locate vaccines and social/financial support if quarantined — global vaccine equity movements and advocacy for vaccine access in Africa