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Community-engaged Mpox vaccination provides lessons for equitable health care in the United States

Nature Medicine volume 29, pages 2160–2161 (2023)Cite this article

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The United States is facing sizable and longstanding challenges on the path to health equity, including persistently inequitable outcomes within healthcare and national public-health initiatives. The number of voices calling for substantive reform of the increasingly expensive and, by international comparison, ineffective US healthcare system is growing. At this inflection point for health equity and health-service delivery, an examination of the current state of sexual health in the United States illustrates several failures and a notable recent success during the 2022 Mpox (formerly monkeypox) response, which highlight actionable priorities for improving the broader healthcare complex.

In the United States, the biomedical, behavioral and structural intervention tools needed to effectively prevent and manage the vast majority of negative sexual health outcomes are widely available, including those for human immunodeficiency virus (HIV) and other sexually transmitted infections and for unplanned pregnancies. Given this, the state of the nation’s sexual health is alarming. For example, HIV prevention and treatment modalities are so effective that ending the HIV epidemic in the United States by 2030 is an attainable goal. Nevertheless, the progress in reducing the estimated number of annual new HIV infections over the past decade is not on track to reach national targets1. Similarly, reported cases of gonorrhea and syphilis, including congenital syphilis, for which reliable tests and effective treatments exist, have increased each year since 2013, reaching a new all-time high in the most recent national data from the Centers for Disease Control and Prevention1,2. Furthermore, access to evidence-based reproductive health services is increasingly being challenged, including by the recent decision by the US Supreme Court to overturn Roe v. Wade.

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Authors and Affiliations

  1. Center for Latino Adolescent and Family Health, Duke University, Durham, NC, USA

    Vincent Guilamo-Ramos, Marco Thimm-Kaiser & Adam Benzekri

  2. School of Nursing, Duke University, Durham, NC, USA

    Vincent Guilamo-Ramos, Marco Thimm-Kaiser & Adam Benzekri

  3. School of Medicine, Department of Family Medicine and Community Health, Department of Infectious Diseases, Duke University, Durham, NC, USA

    Vincent Guilamo-Ramos

  4. Presidential Advisory Council on HIV/AIDS, US Department of Health and Human Services, Washington, DC, USA

    Vincent Guilamo-Ramos

  5. CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment, US Department of Health and Human Services, Atlanta, GA, USA

    Vincent Guilamo-Ramos

Authors
  1. Vincent Guilamo-Ramos
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  2. Marco Thimm-Kaiser
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  3. Adam Benzekri
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Corresponding author

Correspondence to Vincent Guilamo-Ramos.

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Competing interests

V.G.R. reports grants and personal fees from ViiV Healthcare and personal fees from Gilead Sciences, all outside the submitted work; serves as a member of the US Presidential Advisory Council on HIV/AIDS, the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis, and STD Prevention and Treatment, and the HHS Panel on Antiretroviral Guidelines for Adults and Adolescents; and serves on the board of directors of the HIV Medicine Association and of the Latino Commission on AIDS. M.T.-K. and A.B. declare no competing interests.

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Guilamo-Ramos, V., Thimm-Kaiser, M. & Benzekri, A. Community-engaged Mpox vaccination provides lessons for equitable health care in the United States. Nat Med 29, 2160–2161 (2023). https://doi.org/10.1038/s41591-023-02447-9

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