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With places like San Francisco and New York state declaring monkeypox a public health emergency, there’s a key question: how to talk about the virus in the first place.
Monkeypox, also known as hMPXV, has been circulating in the United States since May. As of Friday, there were more than 5,100 confirmed cases in the U.S., according to the Centers for Disease Control and Prevention. The virus causes symptoms similar to chicken pox, such as a rash, fever and headache. It is spread through close physical contact and is rarely fatal.
Although anyone can become infected, the outbreak seems to have most affected men who have sex with other men. This has led some public health officials to question how to raise awareness of the spread of HIV/AIDS without making the first public health mistakes of the HIV/AIDS crisis, when gay and bisexual men face stigma and discrimination.
It’s a difficult conversation, but it’s an important one, said Dr. Joseph Lee, a professor of health education and advocacy at East Carolina University, has studied public health messages.
“We have to make sure we reach the right communities and get the right people involved and say things that resonate,” Lee told NPR. “Because the damage of getting it wrong is real and hard to fix.”
Experts say be honest, but don’t focus on one group’s risk
Determining how the virus affects different populations can be counterproductive and unhelpful, Lee said.
On the one hand, it can make people disproportionately affected feel fatalistic and less likely to seek help, he added. On the other hand, it makes the less affected feel that they are less vulnerable.
“You can understand that there are differences, and that’s important, but that doesn’t mean the campaign has to be the focus or the message. It’s just telling who the messages should go to,” Lee said.
Overemphasis also activates harmful stereotypes, leading to assumptions about why the disparity exists.
Also, don’t stress too much about sex
Monkeypox is not sexually transmitted and sex is the only way the virus can spread. Still, local public health officials are debating whether gay and bisexual men in particular should be advised to abstain from sex during the current outbreak.
Joaquin Carcaño, director of the Latino Commission on AIDS, a community organization, said the guidance is ineffective but could pose a greater risk.
“We know abstinence education doesn’t work for pregnancy, so why are we using it for this?” he told NPR. “When you say no sex, you’re mischaracterizing MPV, also known as monkeypox, as sexually transmitted, which it can be, but that’s not the end of it.”
Carcaño, who is working to debunk misinformation surrounding the virus, also worries that excessive sex may be causing people to defy public health guidelines. Instead, he recommends phrases like “limit physical meetings” and “limit close, long sessions, meetings.”
Tailor your messages for different audiences
The broader the message, the less likely it is to resonate with any audience, said Dr. Tyler TerMeer, Chief Executive Officer of the AIDS Foundation of San Francisco.
“It’s really important to know who your audience is and create a set of messages that resonate and resonate,” TerMeer said.
The foundation launched the online health guide ahead of this weekend’s Up Your Alley festival, a skin and fetish street fair. The page provides specific advice on how to safely attend the event, including wearing latex, participating in slave shows and social distancing at parties.
TerMeer added that the brochure should be accessible, sex-positive and realistic about people’s responses, while also being fact-based. He plans to continue creating customized messages for future events as needed.
Remind people that there are proactive steps to take
Experts are wary of fear-based messaging, especially when it targets historically marginalized communities.
While it is important to emphasize the seriousness of the virus, it is equally important to emphasize the availability of testing and vaccines. In this sense, the epidemic is much more preventable and manageable than the HIV/AIDS crisis of the 1980s.
TerMeer told NPR that he hopes that after public health officials grapple with how to effectively talk about the virus, they can focus on pressing issues like reducing bureaucratic barriers to access to testing and treatment.
“It is unacceptable that we continue to ring the bell to get the resources we need,” he said. “It makes me wonder if it would have been so urgent if it hadn’t affected a community that many of us have long marginalized.”