What we know about giving

Let’s be clear and state three facts.

First, a monkey can be a person with smallpox.

Second, the current epidemic is overwhelmingly among men who have sex with men.

Third, a growing body of evidence and data suggests that male sex is the primary means of transmission of monkeypox.

While it’s true that the virus has other routes, recognizing and reporting these facts is not anti-gay or anti-science, nor is it anti-gay or anti-science advice to members of this community, because they are the people most at risk right now. .

More than 31,000 people worldwide have contracted monkeypox — nearly a third of them in the U.S. — and the Biden administration has declared a public health emergency. All states except Wyoming have identified at least one case.

However, whether for fear of perpetuating stigma or simply using the words “anal sex” in headlines, health officials and the media have been reluctant to talk openly about which sex poses the greatest risk. In Washington, D.C., officials even expanded vaccine eligibility to partially include people of all genders.[destigmatize] people who need the vaccine.”

The public is also at increased risk of contracting monkeypox from clothes worn in stores or from rats in sewers, with medical experts calling themselves pseudo carriers of COVID-monkeypox online. (Experts say neither of these scenarios is anything to worry about.)

All of this, experts say, could actually do more harm than good, according to Dr. Angie Rasmussen, a virologist at the Canadian Center for Pandemic Research and the Vaccine and Infectious Diseases Institute at the University of Saskatchewan.

“The discourse around this is so exhausting: watching my friends who are health advocates trying to get information and vaccines/treatments to people at risk, armchair pundits and powerful advocates saying, ‘HA! and kids are wringing their hands because they got monkeypox in kindergarten,” Rasmussen wrote in an email to BuzzFeed News. “It’s taking a huge toll on the most dangerous people NOW.”

So what does the data say about monkeypox?

Most people with monkeypox are gay, bisexual, or queer men. And when we say overwhelmingly, we mean it.

In an update last week, the WHO said that of more than 8,400 cases with known sexual orientation data, 97.2% were men who had sex with men. Furthermore, 91.5% of the nearly 6,000 types of transmission are sexually transmitted.

“Excluding countries [in the] “The ongoing epidemic of monkeypox in West and Central Africa primarily affects men who have sex with men who report having had sex with one or more partners recently,” WHO said. “There is currently no signal that offers stable transmission outside of these networks.”

A New England Journal of Medicine study published last month looked at more than 500 cases of monkeypox in 16 countries, and 98% of the patients were gay or bisexual men. Another study, published on July 28 in the British medical journal BMJ, involved 197 patients with monkeypox at a sexual health clinic in London. All but one of these men — and they were all men — identified as gay, bisexual, or a man who has sex with men.

In the US, the data is the same. CDC data from July 25 showed that 99.1% of patients were assigned male at birth, and 99% of these males reported having had recent sex with another male.

To explain the clustering of monkeypox among these people, experts say it’s important to think of them not as individuals, but as communities or networks of closely related people.

In other words, the virus didn’t become contagious—it just entered a new network of people.

“I think it’s really about the virus being able to take advantage of network effects and close contact between individuals,” said Amesh Adalja, a senior researcher at Johns Hopkins University Health Center, “and a lot of people use amplification events like flights” with multiple partners who have had multiple close contacts. and some of them were anonymous and this allowed the virus to spread in a way it had not been able to before.

“Maybe he always had that potential,” Adalja said. “That’s the kind of network you need to get into.”

What this data tells us a road Is the monkey disease spreading?

According to the CDC, there are three main ways monkeypox can be transmitted: direct skin-to-skin contact with an infected person; touching contaminated surfaces, objects, or fabrics (ie, fomites); and in contact with the respiratory tract such as mucus (aerosols).

But given that the current epidemic is spreading among these networks of men sleeping with each other, experts say prolonged skin-to-skin contact during sex is responsible for many of these cases.

“Based on the data we have, it seems very compelling to me that sex is playing a dominant role in the spread of monkeypox, and that these patients may be having sex with multiple partners,” Gerardo Chowell, a Georgia state epidemiologist at the University of Public Health in Atlanta, told BuzzFeed News. school said. “That’s why we haven’t seen many cases among heterosexuals.”

According to Rasmussen, if fomites and aerosols are a major cause of monkeypox, the data would point to more cases outside of gay, bisexual or men who have sex with men (GBMSM). “Not all infectious diseases are sexually transmitted, but most are,” Rasmussen said. a road more likely to be transmitted within the family and spread to the wider community.

“GBMSM do not live in isolation: they have children, families, colleagues. If the spread wasn’t primarily sexual, we would see more cases in those people,” Rasmussen added. “But still, there is to add Non-sexual transmission occurs, not so much.

“If it establishes itself within sexual networks, it can spread among heterosexuals as well.”

For its part, the New York Department of Health has counted more than 2,000 cases of monkeypox and lists three possible modes of transmission on its website, but first makes it clear: “In the current outbreak, the monkeypox virus is primarily spread. oral, anal and vaginal intercourse and other intimate contact such as cuddling, hugging, kissing, biting, cuddling and massaging”.

How is monkeypox transmitted sexually?

According to experts, it takes much more than a light brush of skin or shaking hands with a sick person to catch monkeypox; all that is required is to apply it consistently to a person with rashes, scabs, or sores, or to said person’s body fluids. The most obvious and easy way to do this is during sex, but dancing or flirting against a shirtless person at a district party also carries some risk.

The role of sex in the spread of monkeypox has been evident for several years.

This case of monkeypox appears to be linked to an outbreak identified in Nigeria in 2017 that has now spread worldwide.

At that time, the surprised scientists there asked why most of the men in their 20s and 30s got sick and developed rashes on their genitals and not on their faces and limbs. They soon found that many of these patients exhibited high-risk sexual behaviors, such as sleeping with multiple partners and sex workers.

“Although the role of sexual transmission of monkeypox in humans has not been determined, some of these patients may have contracted it through skin-to-skin contact or genital secretions during sex,” said Dimi Ogoyna, professor of medicine and infectious diseases at Niger Delta University, in a 2019 medical journal. wrote with colleagues.

Further research into the current global epidemic has given further strength to this idea, Ogoina wrote in a new analysis published last week in the Lancet medical journal.

Ogoyna pointed to another Lancet study published earlier this month by scientists in Spain, where 92% of 181 monkeypox patients had GBMSM. The researchers found “significantly higher” viral loads, or amounts of monkeypox virus, in the patients’ respiratory samples.

In addition, three-quarters of patients had ulcers around the rectum or genitals, and more than 40% had ulcers in or around the mouth. Also, 45 patients suffered from proctitis, or inflammation of the rectal mucosa, and all but four of these men engaged in anal-receptive sex.

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