“Even though monkeypox isn’t fatal, there are a lot of horror stories like HIV,” says Sawyer, who was on the ground floor of ACT UP in 1987, when the community decided to end the AIDS epidemic. “It’s going to open up a lot of raw wounds, it’s going to bring back the pain that was cut off by the death of so many friends.”
Since May 17, nearly 5,200 cases of monkeypox have been reported in the United States, none of which have resulted in death; The vast majority of infected people worldwide are men who have sex with men, whose extensive and intimate sexual networks are the conduits for the virus, which is spread through close, often intimate, physical contact.
The scourge may not be as serious as HIV or the coronavirus that still causes covid-19, but monkeypox has emerged at a time when gay men in America are feeling stressed and vulnerable. Thinks about Sawyer’s last wave homophobia, including state-level anti-gay laws, and increased threats and attacks against LGBTQ people. A social symptom of monkeypox is the fear that the country will lead to a change in time; In the 1980s, AIDS was first mislabeled in the media as “gay-related immunodeficiency,” and the gay community not only suffered from the disease, but was once again ostracized.
“I fear that a major monkeypox outbreak in the gay community will increase direct, planned attacks on our community,” Sawyer said.
And the community is more visible, stronger, more accepting and more prepared than it was 40 years ago, thanks to the work of people like Sawyer, who helped vaccinate 2,000 visitors to Pine over three weeks in July. Coming out of the AIDS crisis, the gay community helped create the protocols, networks, and models for the pandemic response used to address covid-19, now monkeypox.
“There’s a direct line of heritage in the culture of what we’re doing,” says Keletso Makofane, 35, a social network epidemiologist in New York who conducts rapid research on sex networks and signs of monkeypox. The city is leading a limited vaccine distribution. ACT UP is still an important center for mobilizing people, he says, and queer people are meeting weekly, forming committees and planning collective actions to fight monkeypox.
“This vocabulary comes from emerging movements like ACT UP and Occupy,” says Makofane, who works mostly from her ninth-floor apartment in Harlem. “We don’t build structures from scratch.”
Monkeypox is a very different virus than HIV and 2022 is light years from 1981. But the current epidemic has a spiritual resonance, says Demeter, “a culturally reflexive memory that exists outside of the people who first experienced it.” Daskalakis, 48, is director of the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention.
Public health experts say the government’s response, which has been criticized for a lack of clear communication about testing, symptoms and who is most at risk, has been slow and fragmented. There is a stigma that affects the public for the first time. At rallies, in public health facilities, there is rage against anyone who might be weaponizing the epidemic. And skin lesions! Kaposi’s sarcoma was almost fatal in the 1980s, and now monkeypox pustules are a temporary and non-fatal harbinger of severe disease.
The stakes are much lower, the death and dying, but the agitation high. Any heat rash is suspicious. Every hair that comes out is ridiculous. Recently, gays have been ridiculed on the streets as carriers of disease. Text messages about known exposures — everyday conversations between gay men about common sexually transmitted infections — now have a much more sinister aura. The LGBTQ community scrutinizes every health tip, every candid tweet for slurs or sex-shaming. New adjectives and metaphors are running out to describe the pain that accompanies infection (“visceral,” “excruciating,” “stabbing,” “throbbing”).
“I think we’re all tired,” says Nicholas Diamond, 29, director of editorial services at the Elizabeth Glaser Pediatric AIDS Foundation (and Macofany’s husband). “We may just be seeing the light at the end of the tunnel of the covid-19 pandemic and looking forward to summer, now we have to deal with monkeypox and a government that has really botched its response. COVID-19. So everyone was tired. And it’s hard to talk about anything when you’re worried that your last hookup will make you sick, or that you’ll get sick from your last visit to the bar. I have to wonder if our community was thinking about this in 1981.”
there is It’s a scary thing to sit in a folding chair in 2022, surrounded by other gay men in folding chairs, waiting to be vaccinated by medical personnel in personal protective equipment, immediately wiping down every empty seat with disinfectant. Amanda Carey: Flashbacks manager of the gay sexual health clinic at Whitman-Walker in D.C., describes it — Even at 38 years old, he hasn’t had any personal moments.
On a recent Thursday, Carey told her first monkeypox patient that the testing lab initially prohibited phlebotomists from drawing blood from people with suspected or confirmed cases. Carey was wearing full PPE per CDC guidelines.
“The patient says, ‘Oh, it’s like the ’80s,'” Carey says, noting that the patient is still too young to have experienced the height of the crisis. “This is stigmatization. And it’s also scary, especially in the beginning. With the first couple, I was very reassuring: ‘I’m wearing crazy clothes, but it’s not going to kill you. You’re going to get through it. It’s going to go away. We have a chance to heal.'”
30-year-old DC-area epidemiologist In mid-June, the monkey contracted smallpox, five days of fever and night sweats, swelling of the lymph nodes and pelvis, and genital and rectal ulcers. “Deep, visceral pain.”
“And there’s a trigger of stigma and shame,” said the epidemiologist, who spoke on condition of anonymity because of concerns about stigma. “‘Oh, if you got HIV, you did it in a very sneaky way,’ or, ‘If you got monkeypox, you did it in a very sneaky way.’ Aspects of mental health, disclosure and stigma are all interrelated. How do we get past it?’
One way is to remember a key lesson of the AIDS crisis: to educate communities instead of issuing categorical taboos that reinforce stigma, says the CDC’s Daskalakis, who has disseminated guidelines for safe sex and socializing through social media and influencers.
“Absolutism shuts down people’s thinking,” says Daskalakis. “So really thinking about a harm reduction strategy — where you’re giving people the knowledge they need to make the right choices — is the way we’re going to win.”
Homosexual men had to be open with each other, at the risk of being seen as preachers or ostracized. On July 19, AIDS activist Mark S. “Monkey pox is a gay thing,” King said. We have to say it.’
“Stigma, judgments and homophobia? Of course. We have to deal with it,” King wrote. “But that doesn’t mean we bury crucial facts in vague, evasive statements.”
Sex positivity defines modern gay life, of course, but so does awareness, disease prevention and treatment. Nicholas Diamond helped create a leaflet last month called “Six Ways to Have Safer Sex During Monkey Pox”.
“Girls, we hate to say it, but it might be time to put the group sex and saunas on hold until we all get a shot or two,” Diamond wrote in a quick survey of monkeypox in New York with two colleagues. York, the mayor on Monday declared a state of emergency due to the epidemic. “It’s temporary and out of love for group sex and those who enjoy it.”
The World Health Organization said last week: Guys, it’s a little cool.
“For men who have sex with men, this includes reducing the number of sexual partners you currently have” and “reconsidering having sex with new partners,” said WHO director-general Tedros Adhanom Ghebreyesus.
Stephen W. “What most people don’t want to say out loud is that gay men have more sexual partners on average,” says Stephen W. Thrasher. Thrasher, whose new book, The Viral Class: The Human Cost of the Collision of Inequality and Disease, examines the relationship between systemic injustice and disease vulnerability. “But with the sexual dimension of our lives comes responsibility. This is not just a free orgy.’
The public is sharing knowledge, demanding government action, and promoting harm reduction. On Friday, the spectacular event in San Francisco announced temperature checks, 60 percent capacity and a “consent and health check” at the door, where color-coded wristbands were handed out based on an attendee’s personal space. On July 25, Washington Blade personally hosted a town hall against monkeypox Nearly 50 LGBTQ citizens and public health experts shared advice, observations and concerns. Blade’s colleague in Los Angeles followed suit with his own town hall on July 27, which featured a resident named Matt Ford, who became one of the first American men to share his experiences with the outbreak on social media.
Such testimony combats stigma and makes the problem real for people, said LA panelist Dan Woelfeiler. It also goes back to that earlier time.
“In 1983, I saw a guy named Mark Feldman stand up in a synagogue in San Francisco in front of a crowd this size and talk about HIV,” said Wohlfeiler, who has worked on HIV and STD prevention for decades. “He said, ‘Whoever wants to come to the front of the room and see my wounds, you can come and do it.’ And it was an incredibly powerful moment. Now we have Matt and others coming in and talking about their experiences and symptoms – which thankfully are not that serious, but clearly painful – and I think we really owe Matt and others a big thank you.
But all this is happening because our government has failed to respond proactively, whether it’s describing monkeypox as a ‘sexually transmitted’ or ‘gay thing,’” says Kenyon Farrow. Public health activist in the Cleveland area.
As Thrasher writes in his book, “individual shame narratives not only attempt to shift blame from the state and society to the individual, but also isolate individuals both politically and socially.”
Here, in this current epidemic, there are big lessons from the past—lessons about persistent homophobia, structural racism, and the neglect of past epidemics of monkeypox in Central and West Africa.
“The clearest conversation we need to have – and it’s clear to everyone over the last two years of Covid – is that our public health system is failing us, isn’t it?” says Farrow, managing director of advocacy and organizing at PrEP4All, an organization dedicated to increasing access to HIV drugs. “If we want any chance of not having to deal with infectious disease crises all the time, we’d better start thinking about how to reimagine health in the United States and around the world.”