The first monkeypox case was reported to WHO on May 7. Recently returned from Nigeria, where they caught the virus. Since then, over a dozen nations where the disease is not generally found have reported cases, including many European countries, Israel, the US, Canada, and Australia.
The public and media are morbidly interested. Monkeypox and other uncommon viral illnesses might elicit exaggerated concern. Its “foreign” origin, fear of infection, and idea that it spreads fast and invisibly are factors.
This “germ terror” is heightened by the infection’s temporary obvious disfigurements. Public health measures, such as isolation protocols, PPE-clad healthcare staff, and intensive investigations and contact tracking, are evocative of totalitarian police-state solutions for the crime. As with Ebola in 2014, misleading media and social media can feed public concern.
Recent monkeypox cases did not have travel linkages to endemic nations, raising the potential that the illness spread silently in the population before being recognized. Recent cases involved gay, bisexual, and other males who had sex with men. This is problematic since it risks stigmatizing this group further.
They’ve suffered greatly from the stigma of contagious diseases, especially HIV/Aids, and homophobia still runs deep even in countries with robust LGBTQ+ rights. Despite LGBTQ+ efforts, public education programs, and equal rights legislation, stigmatization persists.
The HIV/Aids pandemic offers lessons. Deeply rooted religious and cultural ideas erroneously associated their sexuality with immorality and promiscuity. Gay and bisexual males were blamed for HIV’s spread, but it was also transferred through heterosexual intercourse, mother-to-child transmission, needle-stick injuries, and contaminated blood products. Racial prejudices and stereotypes exacerbated the stigma for ethnic minority men.
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This damaged the victims’ mental and emotional health. It damaged their social and sexual connections, causing rejection and loneliness. Some changed their health behavior, delaying care. Some were unwilling to reveal their contacts, hindering outbreak investigations and control efforts by public health experts.
How do we stop this epidemic? First, clear, timely, and open public education about the disease helps relieve public worries. Access to credible health information would also help. We must spread the word about monkeypox without fanning fear, mistrust, or alienating guys who have sex with males.
We need to educate the public put the risk of this disease in perspective; it’s mild, self-limiting, and doesn’t spread quickly. We must convince the public that this is not a novel disease; scientists have researched its spread and health repercussions for years. We can reassure exposed people that there’s an effective vaccine.
Not A S*xual Matter
We need to get across the message that monkeypox is not a disease of men who have sex with men. It is not about sexuality: people tend to be infected through close physical contact and it does not have to be sexual in nature. Infected people will tend to infect people they have close contact with, which is why the risk of spread is high in affected households.
So while a high proportion of cases have so far occurred among men who have sex with men, in part this reflects their social networks. It could just as easily have been an outbreak in a heterosexual friendship network, a group of sports people, or occupational group, or other social groups. Would it have carried as much risk of stigma then?
Another danger of mis-portrayal of the monkeypox outbreak as a phenomenon that only affects men who have sex with men is that others who are at risk – for example, household members – may not realize this and fail to protect themselves. We also need to alert and inform travelers about endemic areas in west and central Africa as they may not realize there is a risk there.
NEW: Gay and bisexual men comprise 98% of new monkeypox cases globally, according to a major new study. https://t.co/389MjppEpo
— NBC Out (@NBCOUT) July 22, 2022
Our best chance of snuffing out this outbreak quickly is through early detection and quarantining infected people and protecting their close contacts through vaccination, to break the chains of transmission. As we know all too well from our experience with HIV, stigma won’t help.
