Last fall, we watched friends and loved ones face the outbreak of an infectious disease that was then called monkeypox (now referred to by the less stigmatizing term “mpox”), fearing a repeat of the pattern of restricted resources, misinformation, and medical mistrust that hits hardest in Black and Brown communities. Fortunately, we already had a vaccine available that we could use to fight the outbreak. However, many people who were good candidates for the vaccine weren’t aware of it.
Meet them where they are
Taking vaccines to where communities gather, like churches, barber shops and community centers, is a best practice in public health.  Trusted leaders encourage people in their networks to build their own knowledge and share what they’ve learned with others. This engages people in their own health and leads to health promoting behaviors such as vaccination.
Community leaders, clinicians and public health professionals work alongside Guardians CLE to make COVID-19 vaccines more accessible via the model FCCR Vaccine Uptake Initiative. In addition, as Kate Warren wrote in 2021, Federally Qualified Health Centers (FQHCs) are essential to providing access to COVID-19 vaccines, as well as diagnosis and treatment. FQHCs are trusted leaders who serve low-income people and people of color in medically underserved areas.
Mpox in Cleveland and Cuyahoga County
As we watched our community face a new challenge with the outbreak of mpox locally, public health partners pointed out that Cuyahoga County has experienced more than 150 cases of mpox, including over 1/3 with HIV co-infection and roughly 1/5 who are diagnosed with mpox along with a new diagnosis of HIV or another STI. Greater Cleveland has also experienced two deaths from mpox among Black men. 
In addition, a recent CDC Report details the occurrence of severe manifestations of mpox in the United States, particularly in people living with HIV. The findings indicate significant disparities in mpox case severity for Black men and people experiencing homelessness. In Cuyahoga County, the highest numbers of mpox cases have been seen in zip codes that align with other health inequities.
In Ohio, there are over 25,000 people who are living with HIV/AIDS.
Men who have sex with men (MSM) of all sexual orientations are currently at higher risk for contracting mpox because of the social and sexual networks in which the virus has been spreading the fastest. There have been a number of hospitalizations for severe mpox in people who were diagnosed with HIV at one point, but were not in care.  In Ohio, there are over 25,000 people who are living with HIV/AIDS; over 5,200 of them call Cuyahoga County home. Nearly 80% of people living with diagnosed HIV are males, and the rate for Black/African American people is more than six times as high as that for white people. 
Supporting mpox vaccination with mini-grants
The AIDS Funding Collaborative (AFC) is a funding partnership designed to strengthen the community’s response to HIV/AIDS. We provide coordination, leadership and advocacy as well as funding. This month, the AFC provided mini-grants in order to increase mpox vaccination rates among people living with HIV who are most at risk for severe disease, especially Black gay/bisexual men, Black same-gender-loving men, and other Black men who reside in neighborhoods with low vaccine uptake, and who are most impacted by mpox and HIV.
These mini-grant awards are intended to complement the work of public health officials and clinical providers, and expand local capacity to address the mpox outbreak through focused education, outreach, vaccine registration, individual follow-up, and vaccination events. Grantees will coordinate with vaccination clinical provider contacts at local public health departments and health centers, as needed.
Recipient of the Mpox Vaccine Uptake Mini-Grants
- Healthcare Access Worldwide, Inc.: To provide innovative mpox communication/education and mpox vaccine outreach events in Cuyahoga County’s African immigrant community.
- University Settlement: To provide innovative mpox communication/education and mpox vaccine outreach in Broadway-Slavic Village.
- Ursuline Piazza: To provide mpox vaccine support via transportation and innovative mpox communication/education events in Detroit-Shoreway.
- We Think 4 a Change: To connect clients to mpox vaccine appointments and provide mpox communication/ education via social network outreach workers.
Our commitment to health equity means everyone has fair and just opportunity to achieve their highest level of health. For mpox, this includes reliable access to accurate information and prevention education, as well as vaccine access. Mpox vaccination can prevent disease and also act as an entry point to care for people at risk for and living with HIV.  We’re grateful to all of our community partners for keeping that door open.
What You Need to Know About mpox (monkeypox): Watch a video here.
Find vaccines at mpoxvaxmap.org
 Rogers, E. M., Singhal, A., & Quinlan, M. M. (2014). Diffusion of innovations. In An integrated approach to communication theory and research (pp. 432-448). Routledge.
 Ohio Department of Health, Ohio HIV/AIDS Integrated Epidemiologic Profile (2022), accessed 2/6/23.
 Mussini, C., Guaraldi, G., & Orkin, C. (2022). Monkeypox vaccination – an opportunity for HIV prevention. In Lancet HIV 2022 (p. 1-2).
The AIDS Funding Collaborative (AFC) strengthens the community’s response to HIV/AIDS as a public/private partnership providing coordination, leadership, advocacy and funding in Greater Cleveland. The AFC is located within the offices of The Center for Community Solutions, which provides fiscal and administrative oversight.