“Comes across as a disregard to the LGBTQ community. Mostly because of the historical context in which we live.”
I tried to strike a bit of a balance. Current reporting on monkeypox, particularly from government agencies/public health officials have been pretty terrible, trying to downplay that MPXV is predominantly spreading through sexual activity between men. It has improved a bit but the CDC website, right now, says absolutely nothing about it spreading through MSM. This is so egregiously misleading it amounts to misinformation.
Is it a simple solution?
I made this post because Linch asked me to research a bit and then write up what I found. We had a brief call about what he was thinking and wanted covered and among them was if it was worth it to try and stop the spread by paying people to refrain temporarily. This isn’t a crazy idea. If we were very early on, I might even recommend this course of action. It’s a simple solution insofar as it is pretty simple to describe and if funded, could be put together quickly. Identify those most likely to spread the disease and pay them $25/day to not have sex (or just have sex with a single partner). I suggest this is no longer possible. Nonetheless, this shouldn’t be thought of as an STI. Using protection (condoms, etc.) would do approximately nothing in my estimation and monkeypox is not an STI, it is simply spreading primarily at this point through gay sex and wouldn’t come up on a test for STIs.
(1) I never purported that communicating that monkeypox is transmitted mostly among MSM is tone-deaf in itself. Like I wrote at the end of my comment, I think this information is important. I think it is the way in which you communicated that made it come across as tone-deaf.
(2) the definition of an STI is:
infections that are passed from one person to another through sexual contact. The contact is usually vaginal, oral, or anal sex. But sometimes they can spread through other intimate physical contact. This is because some STDs, like herpes and HPV, are spread by skin-to-skin contact. [link]
Based on this definition monkeypox is just as much an STI as herpes and HIV. A short google search about it seems to communicate that it’s not being called an STI right now since it can cause stigma and stigma can hurt response efforts. But regardless definition has nothing to do with it. You can include it on an STI panel even if it’s not strictly an STI, if it is more effective to do that to curb its spread.
I’m a microbiologist but not an expert in STIs and to me if this is being passed among mostly MSM, reducing the types of skin-to-skin contact that MSM have more often than others, should reduce the spread. Even if it won’t bring cases down to 0.
Current reporting on monkeypox, particularly from government agencies/public health officials have been pretty terrible, trying to downplay that MPXV is predominantly spreading through sexual activity between men.
The only source for this claim you give is US based. I have not investigated this broadly, but the first two countries whose disease protection agencies I checked do make very clear that this outbreak is primarily in men who have sex with men.
“While anyone can get monkeypox, the majority of monkeypox cases in the UK continue to be in gay, bisexual and other men who have sex with men, with the infection being passed on mainly through close contact in interconnected sexual networks.”
Anyone can get monkeypox. Though currently most cases have been in men who are gay, bisexual or have sex with other men, so it’s particularly important to be aware of the symptoms if you’re in these groups.
The German Robert Koch Institut (a federal government agency and research institute on disease control and prevention) on the monkeypox outbreak and cases and situation in Germany:
Die Übertragungen erfolgen in diesem Ausbruch nach derzeitigen Erkenntnissen in erster Linie im Rahmen von sexuellen Aktivitäten, aktuell insbesondere bei Männern, die sexuelle Kontakte mit anderen Männern haben.
(translated: According to most recent findings the infections in this outbreak are primarily occurring after sexual contact, especially in men who have sexual contact with other men. )
I can’t remember if we discussed this in our call, but one thing that’s very plausible to me as an effective strategy is to include monkeypox in the suite of STI tests, at places like Planned Parenthood (I emailed Planned Parenthood but (reasonably enough!) they didn’t get back to me). Also providing free and accessible testing at sex parties, and possibly recommend gating on them.
I tried to strike a bit of a balance. Current reporting on monkeypox, particularly from government agencies/public health officials have been pretty terrible, trying to downplay that MPXV is predominantly spreading through sexual activity between men. It has improved a bit but the CDC website, right now, says absolutely nothing about it spreading through MSM. This is so egregiously misleading it amounts to misinformation.
I made this post because Linch asked me to research a bit and then write up what I found. We had a brief call about what he was thinking and wanted covered and among them was if it was worth it to try and stop the spread by paying people to refrain temporarily. This isn’t a crazy idea. If we were very early on, I might even recommend this course of action. It’s a simple solution insofar as it is pretty simple to describe and if funded, could be put together quickly. Identify those most likely to spread the disease and pay them $25/day to not have sex (or just have sex with a single partner). I suggest this is no longer possible. Nonetheless, this shouldn’t be thought of as an STI. Using protection (condoms, etc.) would do approximately nothing in my estimation and monkeypox is not an STI, it is simply spreading primarily at this point through gay sex and wouldn’t come up on a test for STIs.
(1) I never purported that communicating that monkeypox is transmitted mostly among MSM is tone-deaf in itself. Like I wrote at the end of my comment, I think this information is important. I think it is the way in which you communicated that made it come across as tone-deaf.
(2) the definition of an STI is:
Based on this definition monkeypox is just as much an STI as herpes and HIV. A short google search about it seems to communicate that it’s not being called an STI right now since it can cause stigma and stigma can hurt response efforts. But regardless definition has nothing to do with it. You can include it on an STI panel even if it’s not strictly an STI, if it is more effective to do that to curb its spread.
(3) I do maintain that paying people to abstain is not an effective intervention. Sex isn’t exactly a rational pursuit, and it’d be impossible to reinforce that. Also the CDC does encourage condom use and there is an early study purporting to find monkeypox in semen.
I’m a microbiologist but not an expert in STIs and to me if this is being passed among mostly MSM, reducing the types of skin-to-skin contact that MSM have more often than others, should reduce the spread. Even if it won’t bring cases down to 0.
The only source for this claim you give is US based. I have not investigated this broadly, but the first two countries whose disease protection agencies I checked do make very clear that this outbreak is primarily in men who have sex with men.
The UK Health Security Agency on latest updates on monkeypox:
The NHS Webpage on monkeypox says the same thing:
The German Robert Koch Institut (a federal government agency and research institute on disease control and prevention) on the monkeypox outbreak and cases and situation in Germany:
(translated: According to most recent findings the infections in this outbreak are primarily occurring after sexual contact, especially in men who have sexual contact with other men. )
Fair, at the time, in late July, the NHS didn’t have anything on MSM. The WHO and CDC continue not to. Those were the sources I checked.
I can’t remember if we discussed this in our call, but one thing that’s very plausible to me as an effective strategy is to include monkeypox in the suite of STI tests, at places like Planned Parenthood (I emailed Planned Parenthood but (reasonably enough!) they didn’t get back to me). Also providing free and accessible testing at sex parties, and possibly recommend gating on them.