I got the monkeypox vaccine, but other gay men may not. Here’s why – Grid

I received the monkeypox vaccine on July 29. Why? I’ll be honest with you: My main reason for doing so was that if I got infected and developed skin lesions, my looks might be impacted.

I was not going to let that happen — not on my watch.

So, I went to Eugene Obregon Park in East Los Angeles, where the county was giving out the vaccine. I was able to get a shot because I fall into one of the groups eligible to receive it. I waited inside a community center gymnasium in a long, snaked line with about 60 other people. Forty more people were sitting in the post-shot area to make sure they didn’t have a bad reaction to the dose. The setting looked a lot like the one I encountered for my covid vaccine shots.

The national monkeypox vaccine rollout was already less than ideal — marred by not enough testing locations and low supplies of the vaccine.

But people in the LGBTQ community (or still impacted by the sexual health of the community) faced additional struggles that are all too familiar: stigmas about sexuality and racial disparities.

There is the fear in the LGBTQ community that by accessing sexual healthcare, you’ll be seen as promiscuous. In the case of monkeypox, if that fear prevents someone at risk from getting vaccinated or seeking care, it could help the virus spread. For instance, California, where I live, just declared a monkeypox state of emergency due to an uptick in cases.

When I mentioned to a friend that I got the shot, she asked me how she could get one. I told her that in Los Angeles County, aside from receiving an invite from the health department (which happens if you come in contact with a confirmed case), you have to meet one of three requirements to get vaccinated: being diagnosed with gonorrhea or syphilis within the past year; currently taking pills to prevent HIV infection, a regimen known as pre-exposure prophylaxis (PrEP); or having attended a venue in which anonymous sex with multiple partners took place. She looked at me with a smile, knowing I had qualified.

It’s not the first time the community has faced social stigma over healthcare. The same dynamic played out in 2012, when Truvada became the first Food and Drug Administration-approved HIV prevention drug. Truvada was already being used to treat people with HIV infection. But this was the first time the FDA had approved a drug to protect uninfected people against HIV.

Studies reveal that stigma and homophobia led to a lower uptake of PrEP, a highly effective means of preventing HIV transmission. These issues were exacerbated by media coverage, like a now-infamous Huffington Post opinion piece headlined “Truvada Whores?” by a writer who argued that gay men would see the drug as a pass to engage in sexually risky behavior. And in 2018, the New York Times published an opinion piece by an AIDS historian about the decline of condom use among gay men due to the rise of PrEP.

Fears that the drug will make gay men too willing to engage in risky sexual encounters by the drug led to what news outlets have called a “PrEP closet,” where people who take the drug will not discuss it because they are concerned about how they will be perceived.

Adding to the monkeypox vaccine’s stigmatization, some news reports have framed monkeypox as a “gay disease.” And framing the discussions in that way is likely to affect who decides to stand in that open line and get vaccinated.

And while I, an openly gay man, am not afraid to say I am on PrEP (that’s how I qualified for the monkeypox vaccine), what if I wasn’t open about either of those things? What if I had to stand in this long line as someone not ready to share their connection to the LGBTQ community? This experience would be at a minimum difficult and, quite possibly, even traumatic.

Joey Espinoza-Hernández, the director of policy and community building at the Los Angeles LGBT Center, explained how that can make the population vulnerable.

“You’re really thinking about folks who are disconnected from resources,” Espinoza-Hernández said. “They’re not necessarily going to go to their health provider and proactively provide information around their sexual activity. And so, a healthcare provider may not know to guide them toward the resources that would be the most appropriate for them.”

While waiting to get vaccinated, I noticed a young man dressed all in black who looked terrified. He didn’t make eye contact with anyone. Ironically, it was his apparent efforts to conceal himself that caught my attention.

It might have made it a bit better for him that the vaccine site was not a clinic tailored specifically to the queer community — something healthcare organizations say they do on purpose.

“There’s a lot of people who aren’t going to identify with the community. And so, they’re going to choose not to go to LGBTQ+ health clinics,” said Ahmer Afroz, the executive director of the Utah AIDS Foundation. Consequently, his organization has been trying to reach people by going through both channels.

And while anecdotal, as a Black man, I could not help but notice I was only one of three Black men in line for the shot — not surprising if you go back and look at the studies on who accesses PrEP. Black men who have sex with men are less likely to obtain the drug and to disclose their sexual identity and sexual behaviors to healthcare professionals due to stigma. Health researchers have attributed this to factors like mistrust in healthcare systems, socio-structural barriers and homophobia.

When I was in my late teens, I was home in Cincinnati during college summer break. I remember going into a clinic for routine STD testing, and a counselor there asked me if I had been intimate with someone of the same sex in the past 30 days. I said yes. She made a face that was a mix of shock and horror. Subtle, or not so subtle, signals from those working in these spaces can make it harder for those who need care to seek it.

I thought it was funny, and I’ve never hesitated to get the healthcare that keeps me safe. But if I hadn’t gone to school in Chicago and experienced more accepting communities, the experience may have made me feel immoral. Even worse, I may not have gone to obtain healthcare related to LGBTQ matters in the future.

There are signs, though, that the community may be more inclined to get the monkeypox shot than heterosexuals. Afroz highlights the fact that the Centers for Disease Control and Prevention found that gay and lesbian adults are more likely to be vaccinated against covid than those outside of those communities. While the two are different shots, there are some possible parallels from a behavioral standpoint.

I decided to speak freely about my experiences because there are nuances that the LGBTQ community faces that often don’t get considered. It is uncomfortable knowing my editor and colleagues will know these intimate details about me, but if it helps even just one person, it will have been worth it.

As Scott Wiener, a state senator from San Francisco, recently said on social media: “The monkeypox outbreak is an emergency & we need to use every tool we have to control it.” And if we have learned one lesson from the pandemic, it is that information can be a powerful tool in helping people stay healthy.

Thanks to Lillian Barkley for copy editing this article.

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