For pioneering AIDS activists, monkeypox evokes déjà vu

Four pioneers of the AIDS activist movement watch with a sense of dread and nostalgia as monkeypox spreads around the world.

Some similarities between the two viruses speak for themselves. Like the strain of HIV that started the AIDS pandemic in the late 1970s, the current monkeypox epidemic has been found predominantly in men who have sex with men from sub-Saharan Africa and living in the world’s megacities. Although epidemiologists do not have a complete understanding of how monkeypox is currently spread, recent research suggests that it is sexually transmitted.

The four pioneering AIDS activists of the 1980s and ’90s argue that real-time has other, less effective, but less noticeable parallels.

Photo: People hold signs indicating the number of AIDS victims during an AIDS demonstration in New York’s Central Park on August 8. 8, 1983. (Allan Tannenbaum/Getty Images file)

As in the early days of the AIDS crisis, they argue, government reporting on the epidemic has been inaccurate, gay men have been blindsided, and public health officials have failed to deal with the overwhelming disease sweeping the LGBTQ community.

“It feels like déjà vu,” said gay rights campaigner Peter Tatchell, a leading member of the UK Gay Liberation Front. “Lessons have not been learned from the AIDS crisis and Covid.”

When AIDS began to appear in men who have sex with men in the late 1970s, public health officials around the world were slow to fight AIDS. By June 5, 1981, the United States had published the world’s first government report on infectious disease in the Morbidity and Mortality Weekly Report, a government bulletin on cases of unusual disease.

“Between October 1980 and May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at 3 different hospitals in Los Angeles, California,” the report said. “Two of the patients died.”

Three years later, the US government announced that it had developed an AIDS test in addition to a vaccine, but it never materialized. In 1985, approximately 12,000 Americans died from the disease.

Similarly, activists argue that the global response to monkeypox has been too slow to curb the number of people infected with the virus — more than 20,500 cases of monkeypox have been reported in 77 countries and territories around the world since early May. Disease control and prevention.

Since its discovery in 1970, no one has died from monkeypox except in 11 African countries where the disease has become endemic. However, the majority of monkeypox patients are hospitalized due to severe disease caused by the acne-like lesions that appear. .

Since the first cases were discovered in May, the United States has distributed about 200,000 Jynneos vaccines — a two-dose vaccine to prevent smallpox and monkeypox — to the most at-risk population, including about 3.8 million gay men. In France, only about 6,000 people have been vaccinated in more than 100 vaccine centers in recent weeks, French Minister of Social Affairs and Health Francois Brown said on Monday. And in the UK, health officials ordered an extra 100,000 doses of the vaccine last week to meet growing demand.

Last Saturday, the World Health Organization declared monkeypox a public health emergency of international concern, a designation for the most dangerous global disease outbreak, which it had refused to do so last month. More than two months after the first case of monkeypox was identified in the United States in mid-May, public health officials in New York on Thursday declared the outbreak a public health threat, and officials in San Francisco declared a state of emergency.

“What’s interesting is that most of the scientists and clinicians who were trained or were there at the beginning of the AIDS epidemic, people like Tony Fauci, know this history, but the response to monkeypox was very slow and chaotic,” said Gregg Gonsalves. In 1990, he joined Act Up, the leading advocacy group for AIDS action, and is now a professor of epidemiology at the Yale School of Public Health. “As an individual, it’s like, ‘Three strikes out, man.’ HIV, Covid and now monkeypox? How many times can you repeat the same mistakes?”

Representatives of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci has been in charge since 1984, and officials at the White House, where Fauci served as the president’s chief medical adviser, did not immediately respond to NBC News’ request for comment.

pictures of men waiting in a long queue In addition to clinics around the world to get vaccinated, technical issues Online vaccine portals and reports accusing the US government of developing a “wait-and-see” response to the outbreak – calling for vaccines to be sent only to cases that have emerged in the past few weeks – have fueled activists’ fears. The public health response to monkeypox is a repeat of its misguided AIDS strategy.

People line up outside the Department of Health & Mental Hygiene Clinic on June 23, 2022 in New York City, New York, where vaccines will be available to residents affected by monkeypox.  (Tayfun Koskun/Anadolu Agency via Getty Images)

People line up outside a Department of Health and Mental Hygiene clinic in New York on June 23, 2022, as vaccines are made available to New York City residents affected by monkeypox. (Tayfun Koskun/Anadolu Agency via Getty Images)

Although the virus began spreading in May, the US did not order more doses of the monkeypox vaccine until June. Regulators also had not finished inspecting Denmark’s main facility for monkey vaccines until July, leaving 1.1 million doses ready for distribution in Europe.

“As with the AIDS pandemic, some governments seem to care little if monkeypox only affects men who have sex with men,” said Tatchell, who was returned from a London hospital where the monkeypox vaccine had run out. last sunday. “What other explanation could there be? Governments should have launched emergency vaccination programs for gay and bisexual men two to three weeks ago.

Some veteran AIDS activists also argue that, as was the case during the AIDS crisis, monkeypox messages were not sufficiently prepared to reach the LGBTQ community.

Early AIDS activist Ron Goldberg, who joined Act Up in 1987, presents the America Responds to AIDS public service campaign that the government launched at the height of the crisis in the late 1980s. Many of the commercials featured heterosexual couples and the message “AIDS is everyone’s problem”.

“At that point they were so afraid to talk about gay sex or anything like that that they had to release the message when they were trying to give some information,” Goldberg said. “If it’s happening within a specific population, you need to target your message to that specific population.”

Activists applauded efforts by public health officials not to directly associate monkeypox with the LGBTQ community — many believe it was caused by AIDS, thereby creating a stigma. However, some have argued that repeated statements by public health officials that “monkey pox can get you” mirror the AIDS message that “anyone can get the AIDS virus” and also bypass efforts to warn the most at-risk demographic.

Research overwhelmingly suggests that the current epidemic of monkeypox is largely caused by men who have sex with men. According to a study published last week in the New England Journal of Medicine, 98% of the 528 monkeypox cases researchers analyzed were in men who identified as gay or bisexual. Another recent report by Britain’s Health Safety Agency found that 97% of 699 cases of monkeypox were gay, bisexual or other men who have sex with men.

“The numbers are there,” says Didier Lastrad, who founded the first French chapter of Act Up in 1989. … We are big people, we are adults, we can handle it. Stigmatization is happening anyway.”

The WHO on Thursday recommended that gay and bisexual men limit the number of sexual partners they have to protect themselves from monkeypox and stop its spread.

But with two years of pandemic isolation and big summer events, such as last weekend’s annual Party of the Pines on Fire Island, some activists worry it will be difficult for gay and bisexual men to curtail their sexual behavior.

“You can turn to people in their 20s and 30s and say, ‘Look, this is no joke. You’ve all seen the pictures. You’ve all had friends with monkeypox. You don’t want that,” Gonsalves said.

More broadly, Lastrad said, HIV prevention pills (also known as PrEP), along with scientific evidence that HIV treatment can prevent HIV transmission, have caused gay and bisexual men to fall asleep. steering wheel when it comes to their sexual health.

“The new generation has completely forgotten the story of AIDS. “I keep writing books about AIDS, but no one reads them,” Lastrad said. “Whenever they did, they forgot the reflexes we had because it was a matter of life or death.”

Despite the message, with the global spread of the vaccine, activists fear that the virus will become the same epidemic that the LGBTQ community faced against AIDS decades ago.

“A lot of people are saying we’re over the limit, we’re missing an opportunity,” Gonsalves said. “If it’s true, it’s incredibly serious because this disease doesn’t necessarily kill, but the enormous suffering and cost of all of this is going to be on many, many people, on many health systems and on many health systems, on many communities. who has already suffered.’

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