Why calling monkeypox an STD is more than just a label

“I don’t think we have enough information right now to fully classify it. I think there are some suggestions, but more research is needed,” Adalja said.

“There are other infections, such as syphilis, that are spread by other means than sexually transmitted,” he said. “Zika is a mosquito-borne disease, but it can also be sexually transmitted. The question to me is that we need to be clear about what’s going on physiologically before we can say that.”

Some experts argue that labeling monkeypox as an STD is not only misleading, but could be harmful to public health.

“The downside of saying monkeypox is an STD is that people who don’t have sex immediately think, ‘OK, I can’t get it,'” said Dr. Saju Mathew, a primary care physician and public health specialist in Atlanta.

“A lot of people think it’s like herpes or gonorrhea or chlamydia, so you have to have sex to get it. That’s not true. So it’s dangerous to say it’s only sexually transmitted. That’s misinformation,” he said. “It’s usually transmitted through sexual contact, but it’s not just through intimate contact. It can also be spread through non-intimate contact.”

David Harvey, executive director of the National Coalition of STD Directors, said he and his colleagues still consider monkeypox a “sexually transmitted” infection.

“With the information available now, we know that the primary route of transmission is sexual — sexual contact. Technically, a sexually transmitted infection is defined as the exchange of genital fluid that contains a virus or bacteria. It’s associated with a sexually transmitted infection,” Harvey said. “We need science that clearly shows that this is an infection through semen or genital fluids, and the science is not clear yet, so we call it sexual contact.”

What do STDs do?

STDs, also called sexually transmitted infections or STDs, are infections that are passed from one person to another through sexual contact, such as vaginal, oral, or anal sex. In some cases, these infections can also be spread through intimate skin-to-skin contact, such as herpes and HPV.

STDs have a long history dating back to the archaic era. Some studies suggest that the migration of modern human ancestors may be linked to HPV, types of herpes and other sexually transmitted diseases.
A recent study in Nigeria was one of the first recent reports describing the sexual transmission of monkeypox. In September 2017, the country experienced a major outbreak of monkeypox in humans, and a study was published in PLOS One in 2019. Until now, it was thought that human-to-human transmission was mainly through saliva or respiratory droplets. direct contact with pus or crusts of wounds.

“There is no formal process for labeling an infection as an STD or STD,” Kristen Nordlund, a spokeswoman for the US Centers for Disease Control and Prevention, wrote in an email to CNN on Monday. “Professionals generally scientifically determine whether an agent can be sexually transmitted, in which case it is called ‘sexually transmitted.’ This will be used to guide the decision.”

He said monkeypox is more accurately described as “sexually transmitted” because sex is one way the virus spreads, but not the only way.

“Sex is a human behavior. If the stigma wasn’t attached to sexually transmitted infections, the implications of saying monkeypox was an STD for people who were more severely affected would be less,” Nordlund wrote. “It’s also important to look at this question globally — and keep in mind that the consequences of this label vary depending on where you are in the world. For example, there are countries where homosexuality is punishable by prison or even death. Labeling monkeypox. STDs or STDs are huge in these countries. may have consequences.”

What is monkey pox?  Symptoms, risk factors, treatment and transmission of the virus

Monkeypox virus can be spread through skin-to-skin contact, either through direct contact with an infected person’s rash or scabies, or through direct contact with their respiratory tract. Scientists are investigating whether monkeypox can be transmitted through semen or vaginal fluids.

Although the risk is low, there is some potential The virus is spread through objects or surfaces used by a person with monkeypox, such as clothing, bedding, or towels.

Matthew said skin conditions caused by monkeypox infection can actually be mistaken for common STDs like herpes or syphilis, and in some cases, a person with monkeypox can develop common sexually transmitted diseases.

When he treated his first patient with monkeypox in Atlanta, Matthew immediately noticed the typical human facial lesions. But the 25-year-old also had pain in his hips, Mathew said. “Besides monkeypox, he got another STD,” herpes.

Mathew added that about 25% of people with monkeypox in the US have a co-infection with an STI.

Colleges focus on training students to prepare for monkeypox outbreaks

Harvey said “when diagnosing monkeypox, you should test for monkeypox, but you should also do other STD tests to make sure they are ruled out or diagnosed.”

“We have the highest rate of sexually transmitted infections in the United States, basically in American history. So it’s not surprising that we’re seeing more STD diagnoses in the context of the current monkeypox outbreak,” he said. “Anecdotally, we’re hearing from some of our clinics around the country that they’re seeing 15% to 40% infection rates with other STIs, but we don’t have national data on that right now.”

CDC clinical guidance advises health care providers: “Comprehensive STI evaluation is important in patients presenting with genital or perianal ulcers. However, monkeypox and STI co-infections have been reported, and the presence of an STI does not rule out monkeypox.”

combating stigma

Any attempt to label monkeypox as a sexually transmitted infection “reinforces stigma and ignores other transmission routes,” Jason Farley, a nurse scientist and the Johns Hopkins University School of Nursing’s inaugural chair of leadership and innovation, wrote in an email to CNN. .

“The virus is spreading among intimate contacts and sexual networks between gay men, bisexuals and other men who have sex with men. We have also seen, although so far limited, the spread in households with infected men, women and children. The latter. It can be transmitted through skin-to-skin contact between parents and children, but also through environmental contamination, Farley wrote.

“If you look at how the AIDS response unfolded, for example, it took almost a decade for the heterosexual community to pay attention and realize that HIV is not a gay disease,” he wrote. “We cannot allow the same form of misinformation to permeate our public health practices today.”

Harvey, a member of the National Coalition of STD Directors, said stigma is something STD clinics struggle with every day, and she’s concerned. about how monkeypox is stigmatized in the context of sexually transmitted disease.

“We don’t want people to dismiss it as a sexually transmitted infection, but to some extent we have to buy into the stigma of sexually transmitted infections,” she said. “So for those of us who work full-time in this field and deal with these issues day in and day out, we want to do everything we can to remove the stigma, especially around sexually transmitted infections, so we can ensure that people can get tested and treated without shame or fear.”

Overall, whether or not monkeypox is called an STD, Harvey said the response to the outbreak is straining STD clinics.

“STD and sexual health clinics across the country are now overwhelmed with testing and treatment needs — and they don’t have the extra funding to handle the flow of patients. We’re also seeing an increase in testing for sexually transmitted infections, and care is already being disrupted.” is lying,” said Harvey.

In a July 26-29 survey of more than 80 clinics conducted by the National Coalition of Primary Care Directors, 63% received referrals from other health care providers for suspected monkeypox, and 52% served people who had been turned down by other health care providers. other providers, while 40% experienced unanticipated costs for equipment or personnel due to the monkeypox response.

Also, 65% of clinics had to change workflows to manage monkeypox, such as moving from walk-in clinics to appointment-only, and 22% had to reduce symptomatic or asymptomatic screening for other STIs to prioritize monkeypox services.

There is “a lack of additional funding, a lack of federal funding, that could directly support these programs,” Harvey said. said. “These programs need support to fund equipment, testing, testing, they need additional staff hours and other opportunities to help them respond to this outbreak.”


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