Monkey pox and sex: NPR

People line up to get the monkeypox vaccine.

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Spencer Platt/Getty Images

People line up to get the monkeypox vaccine.

Spencer Platt/Getty Images

According to the World Health Organization, men who have sex with men are still overwhelmingly the most affected by monkeypox. This has created some barriers when it comes to public health messages about how people can protect themselves. From what we call the virus to advice on how to prevent infection, gay and bisexual men are at risk of being stigmatized.

But experts say despite the threat, it’s important to keep sex front and center in the monkeypox conversation.

“You really have to know exactly who is at risk and what the routes of transmission are,” said epidemiologist Chris Behrer, visiting director of the Duke Institute for Global Health.

Although it is possible to contract monkeypox through non-sexual contact, such as by touching cloth used by someone with monkeypox, such cases are extremely rare. Before the current epidemic, sex between men remained the main mode of infection, of which especially during vaccine shortages should be remembered. “During vaccine shortages, you have to use vaccines and break chains of transmission,” Behrer said. “It’s important to try to stop the outbreak by getting a high level of population immunity in the areas where it’s spreading.”

One of the biggest public health challenges has been curbing risky behaviors that involve sex, Behrer said. In other words, advising queer and gay people to reduce the number of sexual partners and avoid intimacy with strangers.

A message that reverts to the original HIV/AIDS message.

“And when sexuality was such a big part of identity, people noticed that there were elements of homophobia and antisexism,” Behrer said.

How to have sex in an epidemic

Jennifer Brier is an HIV/AIDS historian at the University of Illinois at Chicago. As debate rages over how to talk about monkeypox, for example, is monkeypox considered an STD? What should we make of the actors who call it the “gay disease,” he addressed one of the formative texts of public health. How to have sex in an epidemic. The two were written by Michael Cullen and Richard Berkowitz in response to the lack of information from the government.

Although the booklet contains direct and comprehensive information about the dangers of sex during the HIV/AIDS crisis, it originally began as a script titled “We Know Who We Are: Two Gay Men War on Promiscuity.”

“People went banana pants in that article,” Brier said. Like, “You’re attacking gay liberation, who are we?” I kind of understand that, but they tried to develop a model of harm reduction before it happened.

It’s a playbook that people are still learning from today. Nick Diamond is a co-researcher with RESPND-MI, an effort to collect data on the sexuality networks of queer and trans people in New York City. And in July, in response to local, state and federal officials’ lack of information about monkeypox, Diamond co-authored the document, “Six Ways We Can Have Safer Sex During Monkeypox.”

“I’ll be the first to say that we’re working around our monkeypox effort, relying on AIDS activists,” Diamond said.

But he adds that it’s an imperfect line to draw. HIV/AIDS was a very dangerous disease and emerged in a different political time. And according to Almaz, people still have a hard time talking about queer and trans sex.

“When we talk about monkeypox, we have to talk about sex. I think it’s an uncomfortable conversation, but it’s one of the determinants of our health and our rights,” Diamond said.

And in doing so, it’s important to talk about the commonality of human sexuality. While men who have sex with men are currently at the center of monkey disease, HIV/AIDS historian Jennifer Brier says a specific change in phrasing could lead to restrictions. Men who have sex with men are not only with men, but vice versa.

“Our sexual desires and sexual practices are much more complex than any phrase would give us,” he said.

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