A disproportionate number of cases in the recent monkeypox outbreak have shown up among gay and bisexual men. And when public health authorities investigate the possibility of sexual intercourse or other close physical contact at Pride events in the Canary Islands, saunas in Madrid, and other gay venues in Europe, government officials strive not to select groups that hold. Terrible stigma at the height of America’s AIDS crisis.
“Experience shows that stigmatizing rhetoric can quickly disable evidence-based responses by pushing a cycle of forgiveness, shunning people from health care, hindering efforts to identify cases, and encouraging ineffective action, punishment,” Matthew Kavanagh, Joint deputy executive director. The UN Program on HIV / AIDS, recently said. For years, after the HIV outbreak, fear of punishment or shame has prevented some gay men from being tested.
But as a gay man who studies the history of infectious diseases, I worry that public health leaders are not doing enough to directly alert men who have sex with men about smallpox. Gay men are not the only people at risk, but they should know that, right now, the situation seems to spread most actively in their communities. In recent days, CDC officials have acknowledged this directly. Director Rochelle Walensky noted Thursday that, of the nine cases of smallpox that were identified in the United States in the middle of the week, the majority were among men who had sex with men.
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But many strongly good officials seem afraid to say homophobic things, and news outlets have published articles that assert that monkey smallpox “is not a gay disease.” Caution they are needed, but health agencies put gay men at risk unless they prioritize them for interventions such as public awareness campaigns, vaccines, and tests.
Smallpox, which is associated with smallpox and causes symptoms that include a rash, was not previously seen as a sexually transmitted infection, but many people with the disease recently showed symptoms, such as lesions around the genitals or anus, consistently. with sexual transmission. Public health officials should work with gay community health centers and other LGBTQ organizations to deliver information about smallpox symptoms to doctors and patients.
Although gay activist groups and clinics can carefully monitor the outbreak, I am concerned about gay men in areas where doctors may not know the pathophysiology of the virus. Therefore, public health agencies should also hit gay social media applications and other online platforms to tell users that men who have sex with men have been infected with the virus. These outreach efforts should pay special attention to the most marginalized people who can be at risk. In the past, HIV prevention and treatment efforts reached white men but not a large number of men of color and working class and poor men who were infected with the virus.
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For the moment, both the media and public officials continue to frame monkeypox as rare. I understand instinct is not overreacting. But although the number of documented cases remains small, the notion that the outbreak is an anomaly is misleading medical authorities, journalists, and even gay people themselves 40 years ago, when HIV first entered the headlines. AIDS is routinely framed as a common disorder among small groups of gay men in San Francisco and New York, but the pathogens that cause it have spread far more widely. I worry that people make the same mistake when HIV first appears.
The United States is still dealing with the baggage of the HIV/AIDS crisis. In the 1980s and early 1990s, confusion reigned, and some Americans worried needlessly about having incidental contact or even being in the same room with people with AIDS. Public health campaigns try to alleviate anxiety by creating subway ads that show gay couples and couples directly smiling to emphasize that HIV is not spreading that way or talking about condoms to promote safer sex. This effort is worthwhile; issuing reliable information about how the virus is transmitted, and how it can be avoided, is important for maintaining public health.
However, for fear of stirring up animus against gay men, officials may now be underplaying the role of sexual transmission in recent monkeypox cases.
The virus spreads as a direct result of physical and social conditions. COVID-19 has a greater opportunity to deploy in crowded indoor environments than along hiking trails. Similarly, monkeypox does not require sexual contact but is prone to spread in situations where people with exposed skin are together in close quarters. Like HIV, monkeypox does not check your sexual odometer; The virus does not count the number of partners owned by all and connects to the one that has the largest number. They seek opportunities to spread-and some strange spaces, especially where people meet for sex, create conditions that allow that to happen.
Places where gay people gather nearby have helped define community. When public health authorities close baths during the onset of HIV, many gay people see the closure as a violation of their release. (Conversely, in March 2020, when public health officials close cinemas and stadiums, many Americans are sad to see these places temporarily close, but it’s not important for anyone’s basic identity.) Although I don’t suggest that the government impose. ban in queer spaces, health agencies ought to tell gay men that monkeypox can indeed spread sexually.
Authorities should be able to send that message without morals about patron behavior. Historically, when public health is threatened, the urge to judge with shame has been strong – as demonstrated by the HIV / AIDS crisis and COVID -19. Especially before the coronavirus vaccine was available, people were sharply criticized on social media or in person even for harmless behaviors, such as going to the beach or jogging outside without a mask.
But health and community officials need to be able to distinguish between using the virus to attologize the entire community and recognize that certain physical and social conditions actually lead to a higher risk of infection. Giving gay men carefully tailored warnings about the risk of monkeypox may be a form of education, not a form of stigma.
Instead of treating baths, clubs, and dance parties exclusively as the spread of infectious diseases, they should be recognized as potential promoters of sexual health. For decades, it has been common to find buckets of condoms at the entrances of many bars, along with posters and leaflets with information about safe sex. The LGBTQ committee has many practices with informing the community about possible health threats and proposing safe sex practices.
Public health officials should activate those resources rather than tiptoe around the issue. If gay men are at risk of a monkeypox outbreak, we should know that explicitly — rather than being told — that the condition is rare and usually occurs in other parts of the world.
