Monkeypox and the gay community
This weekend marks the end of Pride Month, as cities across the country hold events to celebrate the LGBTQ community.
It’s also a difficult time for public health: a global outbreak of monkeypox is concerning, with many cases clustered around men who have sex with men.
The experts are now trying to find a delicate balancewarning people who may be at higher risk, without stigmatizing a community that has often been the scapegoat for health problems in the past.
To find out more, I spoke to Gregg Gonsalvesassistant professor of epidemiology at the Yale School of Public Health and global health activist.
Why do many cases of monkeypox occur in men who have sex with men?
It is an epidemiological accident of history. It’s not a gay disease; it has been circulating in West and Central Africa for many years. We have viral zoonoses that jump from animals to humans all the time.
What probably happened in this case is somebody who had monkey pox got a lesion and showed up at a gay rave in Europe, and it spread to those in that social and sexual network. And because the virus prefers close physical contact as a means of transmission, it has found a very suitable environment in which to spread.
Is monkeypox sexually transmitted?
Not as far as we know at this time, in terms of transmission through vaginal or seminal fluid. But sex involves close body contact. It is therefore difficult to distinguish what is happening until we have more studies of the cases that have emerged so far around the world.
How should I think about my risk?
Monkeypox has found a foothold – not in all gay men – but in a certain subset of gay, bisexual and trans men who have been associated with these parties. That being said, the possibility of him moving to other populations within the LGBTQ community or further afield is possible.
People should know the facts. [The C.D.C. has a fact sheet about social gatherings and monkeypox.] We have 173 cases nationwide, but that’s probably just the tip of the iceberg as it’s quite difficult to get access to monkeypox testing, and we’re likely to have substantial spread among this network of gay men with multiple sexual partners in New York.
So, you know, people should be like, “OK, should I go out tonight to go dancing at a club or go to one of those big LGBTQ pride events?” “Think about it. If you’re going to go out and have sex, think about how you’re going to do it in what kind of setting, what kind of place. If you’re going somewhere where you might end up having sex with multiple partners in one night, consider that too.
And think about your own health. If you have a fever or swollen glands or any other early symptoms of monkeypox, and certainly if you see a lesion, you should go get tested and talk to your clinician. And don’t go to these events if you feel sick.
How is the LGBTQ community reacting?
This isn’t the first time the LGBTQ community has taken part in the rodeo, is it? The gay community knows how to deal with infectious diseases. Remember the Covid outbreak in Provincetown in 2021? The gay community there sprang into action and helped the Massachusetts Department of Health and the CDC with contact tracing because they knew how to do it. Everyone sprang into action and were absolutely essential to what was happening during this outbreak.
So while the nature of our social and sexual networks may have made us vulnerable to this infection and its spread, our resilience and perseverance against infectious disease threats over the past 40 years also makes us a fairly capable enemy of the virus.
What should we be doing that we are not doing?
We want to contain this epidemic. So it’s not just about educating people about managing your individual risk, it’s about dealing with a new outbreak that we could potentially contain and snuff out before it takes hold in the long term. in the gay community. So that means we need everyone on deck. Public health departments and LGBTQ and AIDS organizations should cooperate and say, we’re going to send our prevention people to clubs, sex venues, and Pride events.
Another lesson of the Covid pandemic: we must act quickly. Getting vaccines for this is going to be important, but Jynneos – which is the less problematic of the two main vaccines – is in short supply. Montreal has already started vaccinating men who have sex with men who have two or more sex partners. New York City recently announced that it will also vaccinate men who have sex with men. But we haven’t done that generally in the United States yet, so we’re behind the times.
Maybe it will run out, maybe not. But unless we up our game, we are certainly heading down the path of letting this virus persist in our communities. The point is, there’s no time to waste now.
Learn more about monkeypox:
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The good news? We are far from “How dare they!?!” tension that has dominated most of our pandemic lives. The bad news? It is not because the disputes have been resolved. On the contrary, these differences slowly eroded certain relationships until a deep canyon opened between them. The further they go, the less those who are at sea care about what happens on land. And so with us. The tension with our local church eroded into a burst of relief at the thought of joining a like-minded church elsewhere. The tension with the defiant family members eroded to “I wonder if/when we’ll see such-and-such again.” The tension with those in our community who refused to put others first eroded into new friendships with some of the most compassionate people we have ever met. The tension is gone, but in its place is a vast and (perhaps) impassable canyon – a haunting and empty reminder of what was once full.
— Alan K., North Carolina
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