In Louisiana, Black men more likely to get monkeypox, white men more likely to be vaccinated – Louisana Illuminator

In a small parking lot outside of one of Baton Rouge’s few gay bars, health care workers remained upbeat, even as they admitted they had hoped for a bigger turnout to their monkeypox vaccine drive.

Only 13 people showed up during the three hours a mobile vaccine clinic was open a few feet from Provo’s Cedarcrest Bar on a late September evening. A few weeks earlier, a similar event at this same Airline Highway bar drew 50 people. 

People need two shots about a month apart from each other to be fully inoculated against monkeypox. State health officials had hoped to see more people from the first event circle back for their second dose. 

Louisiana also needs to make inroads with the Black LGBTQ community on monkeypox, and Provo’s – as the venue is called – is the only LGBTQ bar in Baton Rouge with a predominantly Black clientele. 

In Louisiana and across the country, an overwhelming majority of monkeypox cases have been found in men who have sex with men as well as transgender and nonbinary people who have sex with men. Lesser known is that the outbreak is disproportionately affecting people of color. 

Nearly 60% of Louisiana’s 269 monkeypox cases have been found in people who identify as Black or African American, but they make up only 24% of the 8,800 people who have received at least one monkeypox vaccine shot in the state, according to health department data.

 By comparison, white people account for just 28% of the state’s monkeypox cases so far, but have received 55% of the vaccine doses.

Those numbers are in line with racial disparities in monkeypox infections and treatment at the national level.

Monkeypox cases have drastically declined in the United States, but Black people make up a growing share of new infections. The Black community accounted for 50% of U.S. monkeypox cases in the last week of September, though only 12% of those vaccinated, according to the U.S. Centers for Disease Control and Prevention. 

Monkeypox racial disparities are also acute in a state like Louisiana, which has one of the largest Black populations in the country. Nearly a third of Louisiana residents are Black or African American, compared with 14% nationwide.

Lessons from COVID, HIV/AIDS

The Louisiana Department of Health is using a number of strategies picked up during the early days of the COVID-19 vaccine drives to try and close the gap on monkeypox treatment in the Black community.  This includes holding vaccine drives at Black LGBTQ bars. 

Charlotte Provo, the owner of Provo’s, said she readily agreed to host three vaccine drives at her bar, especially after someone she knew contracted monkeypox. The Black community can be more reluctant to participate in public health initiatives like vaccine drives, given the country’s history of conducting medical experiments on Black people, said Provo, who is Black. 

“It extends back to Tuskegee,” Provo said, referring to the 40-year syphilis study that was conducted on Black men in Alabama without their consent until 1972.

“No one wants to be experimented on,” she said.

Provo said she personally convinced about 15 customers to get the monkeypox vaccine during the first drive held at her bar, though the free drinks that came with proof of vaccination might have assisted in her efforts.

“Sometimes it helps to put this right stuff right in their face while they are drinking,” she said.

Willie Mack has also sponsored monkeypox vaccine drives at The Page Bar in New Orleans. Located in the French Quarter, the R&B venue caters mostly to Black customers. Mack has owned it for nine years.

Making the vaccine available at bars like his is beneficial, Mack said, because gay, Black men are reluctant to go to medical clinics or make appointments with doctors.

“The treatment you get at those [medical] places is really, really bad,” said Mack, who is both gay and Black. “If we have the vaccine here, we can have familiar faces here and you won’t be given bad treatment because you’re gay.”

The Page Bar has been engaged with public health for several years under Mack’s ownership. The bar owner, 59, lived through the AIDS crisis of the 1980s and 1990s, and said he thinks the LGBTQ community needs to be proactive about protecting itself. He requires The Page’s staff to be fully vaccinated against monkeypox, COVID-19 and the flu. 

The Page Bar’s monkeypox vaccine drives – where 900 people were given shots over two events – were among the most successful in the state, Mack said. That might be because he has had experience with public health events.

Prior to the COVID-19 pandemic, The Page also held a “PrEP party” to encourage people to start taking medication that can prevent HIV infection. He also runs condom drives and hosts testing at the bar for sexually transmitted infections, where he offers discounted cocktails to those who participate.

“We get a lot of pushback,” for incorporating public health messaging into the bar’s culture, Mack said, but “I don’t care. … I held my friends’ hands and watched them die [of AIDS].”

Barriers to more vaccinations

In August, state health officials also conducted a survey of gay and bisexual Black men to learn about the barriers to getting the monkeypox vaccine within that community. 

In addition to throwing events at bars, the health department has paid for advertising on social media apps used mostly by Black gay and bisexual men. They’ve also asked Black LGBTQ social media influencers, including Big Freedia and HaSizzle, to raise awareness about monkeypox. 

But not everyone is pleased that monkeypox vaccination campaigns are focused so heavily on the LGBTQ community.

“I don’t think we are dealing with this in a smart way,” said Thomas LaVeist, dean of Tulane University’s School of Public Health & Tropical Medicine.

LaVeist said monkeypox is being regrettably pegged as a “gay disease” though people who aren’t gay can still contract it. 

“Homosexuality has certainly become less stigmatized [in the Black community], but I think it is fair to say it is still stigmatized in large portions of the Black community,” said LaVeist, who is Black and an expert on disparities in health care access and outcomes for African Americans.

“I think that may be why you are seeing lower rates of vaccination [in the Black community],” he said. “Someone who is closeted may be less inclined to seek care.”

Monkeypox has primarily spread in the United States during sexual encounters, according to several experts, and there’s increasing evidence the virus spreads more easily through anal sex. But people can contract monkeypox without a sexual encounter at all. Those who live with a person who is infected, in particular, are vulnerable to the illness.

LaVeist said he fears the public health sector is repeating a mistake made with HIV and AIDS, which was initially characterized as a “gay disease.” In recent years, HIV infections have soared among Black women. In 2020, they ranked just behind gay Black men in terms of HIV diagnoses in Louisiana, according to state health data. 

“We did it before and how did that turn out?” LaVeist said. “It’s not a gay disease. Monkeypox is not a gay disease.”

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