WHO advises gay, bisexual men to limit sexual partners

People gather outside the Test Positive Aware Network nonprofit clinic in Chicago, Illinois, July 25, 2022.

Eric Cox | Reuters

The World Health Organization on Wednesday recommended that gay and bisexual men limit the number of sexual partners they have to have to protect themselves from monkeypox and help slow the spread of the fast-spreading virus.

WHO monkeypox expert Rosamund Lewis said men who have sex with men are now the group most at risk of infection. According to Lewis, 99% of cases are among men, and at least 95% of cases are men who have sex with men.

WHO chief Tedros Adhanom Ghebreyesus said it was vital for public health authorities to protect human rights by combating stigma and discrimination, and to engage communities of men who have sex with men to reduce the spread of the virus and care for those infected.

“For men who have sex with men, this includes reducing the number of sexual partners, reconsidering the possibility of having sex with new partners and exchanging contact information with all new partners for follow-up, if necessary,” Tedros said.

Tedros has called on social media platforms, technology companies and news organizations to stand up against misinformation, which he warned will fuel the epidemic.

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“Stigma and discrimination, like any virus, can be dangerous and can fuel an epidemic. As we have seen with Covid-19 misinformation, and this information can spread quickly on the Internet,” said the WHO chief.

According to the WHO, there are now more than 18,000 cases of monkeypox in 78 countries. About 10% of people with monkeypox are hospitalized for disease management. According to the WHO, five deaths were reported in Africa.

The World Health Organization declared a global health emergency over the weekend in response to the outbreak as cases rose rapidly. The current outbreak is highly unusual because the virus is spreading widely in Europe and North America, where the virus is not normally found. Historically, monkeypox has spread at low levels in remote areas of West and Central Africa, where the virus is carried by rodents and other animals.

Europe is currently the epicenter of the global epidemic, accounting for more than 70% of monkeypox cases. According to the World Health Organization and the CDC, about 25% of monkeypox cases are reported in the Americas, and the US is the epicenter of the Western Hemisphere.

The US has reported more than 3,500 cases of monkeypox in 46 states, Washington and Puerto Rico, according to the Centers for Disease Control and Prevention. The United States has the second highest number of cases of monkeypox after Spain.

Scientists from the World Health Organization and the CDC believe that monkeypox is spread primarily through skin-to-skin contact during sex. According to Lewis, if people do not take precautions by limiting the number of sexual partners and having anonymous sex, the virus has the potential to spread widely.

“If there is no intervention in a situation where there is continuous skin-to-skin contact, perhaps in the context of multiple partnerships or contact with anonymous partners, then this becomes a situation where the virus is not involved. can spread more easily,” Lewis said.

People who have contracted monkeypox in the past have transmitted the virus to fewer than one person on average, which is why past outbreaks have not spread widely. But Lewis said a person infected with monkeypox could spread the virus to more people now because smallpox vaccination is less common and global immunity has declined. Monkeypox is in the same family as smallpox, but it causes a milder illness.

Andy Seale, WHO’s specialist adviser on STDs, said experts could not conclude whether monkeypox was a new type of sexually transmitted infection, but that it was transmitted during sex. It’s unclear whether condoms help reduce the risk of infection because monkeypox is spread through physical contact, similar to herpes, Seal said.

“The critical part is really focusing on close, intimate personal contact, prolonged contact as the primary route of transmission during sex,” Seale said. Scientists in Spain and Italy have found monkeypox DNA in semen samples taken from patients, but it’s unclear if the virus is actually spread that way.

Although monkeypox is primarily spread through sexual contact, anyone can contract the virus through close physical contact. This includes, for example, hugging and kissing in the family, as well as soiled towels or bedding. During the current outbreak, women and children have been infected with the virus, but there is currently little community transmission.

Monkeypox can also be spread by respiratory droplets when infected people have sores in their mouths, but this requires prolonged face-to-face contact. If people limit their exposure now, the outbreak could still be contained, Lewis said.

“Isolation is critical for anyone with monkeypox to protect others who live in their household or who may have come into contact with them,” Lewis said. “This is the first time that domestic transmission has been discovered, and in some circumstances it can be transmitted in households.”

According to the US CDC, most people who contract monkeypox recover within two to four weeks. But the virus causes a rash that can be very painful. In the past, monkeypox started with flu-like symptoms and then developed into a rash that could spread throughout the body.

But in the current outbreak, the symptoms of monkeypox were unusual. Some people develop a rash first, while others have a rash without any flu symptoms. Many people develop a localized rash on their genitals or anus.

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