Monkeypox: What Can We Learn From HIV? – Forbes

You have to be careful when comparing any infectious diseases to another. But when it comes to HIV and monkeypox, there are some clear parallels.

Even recent history with Covid-19 shows us the poorest countries and most marginalised communities are most likely to miss out on medication and prevention efforts. That is also the story of monkeypox.

It’s been endemic in Central and Western Africa for many years. The first case in humans can be traced back to the 1970s. But because it’s a virus that has mostly affected black bodies, in countries where governments wouldn’t be able to afford drugs – there has been little commercial incentive to do research.

That’s changing now the outbreak is also affecting people in wealthy global north countries, including the U.K. and U.S. But similarly to the early days of HIV, because it’s affecting mostly gay, bi and men who have sex with men, there has been less of a rush to resolve the outbreak, particularly in the U.K.

That’s despite it being named a global health emergency by the World Health Organisation. So what can we learn from HIV when it comes to tackling both the outbreak and the stigma around monkeypox?

The parallels between the response to HIV, and monkeypox

“I do see parallels to the early AIDS response to what we’re seeing around monkeypox,” Susan Cole, community engagement officer at NAM AIDS Map tells the What The Pox? podcast by QueerAF.

“We saw a great deal of of negative messaging in the media about HIV. And there has been elements of that with monkeypox. But there also hasn’t been as much interest this time. I think that is related to the fact that it is primarily affecting gay men and other men to have sex with men.”

Cole also notes that the lack of, and mixed messaging – is similar to the early AIDS response. The show looks at how this is causing a “detrimental” impact. The HIV expert also believes it’s contributing to a building stigma. This is stopping people from getting checked out if they have symptoms.

Equally, she sees similarities to HIV care in the U.K. with how monkeypox is being handled. Her treatment and care at her HIV clinic is always “excellent”. But when she visits her GP or wider health services, the understanding around HIV dissipates.

This is something that monkeypox sufferers have remarked on the show too. In sexual health settings, healthcare professionals are getting to grips with the virus. But beyond these settings, there is confusion, panic, and alarm.

It’s why the U.K. Health Security Agency (UKHSA) released a new set of guidance to all UK health bodies just this week.

Lessons from language about HIV that can help in the monkeypox outbreak

HIV experts are always careful to put the person at the center of any language about the virus. Rather than talking about someone who is infected, you’ll hear experts talk about people living with HIV.

There is a lesson in this for monkeypox. By focusing on the person, you can decrease the stigma attached to the virus.

“When people call it a ‘gay disease’ we have to remember, it doesn’t have a judgment,” Matthew Hodson, executive director of NAM AIDS Map tells the podcast. “It’s a virus! It doesn’t have motivations. All it needs to do is survive. And it will do whatever it can survive it doesn’t care if it’s host is gay, straight, or a unicorn.”

Of course, this begs the question – how do you do this, while getting the information to those who need it most? In this current outbreak in the U.K. that is gay, bi men who have sex with men.

“The big lesson I learned from working in HIV is that you inform, equip and empower people with information about monkeypox,” Hodson says.

While monkeypox researcher Dr Chloe Orkin also suggests you can talk about sexually active LGBTQ people to focus the language on those most at risk.

But mostly, it’s about making sure people with lived experience are part of the process of designing health messaging. So it matches up with their experiences.

Tackling health inequalities, will solve both HIV and monkeypox

Among scientists, virologists and sexual health experts – there is a great deal of concensus. When you fix health inequalities, you can fix and even end all kinds of diseases.

That’s why there was much discussion during the covid pandemic was about securing vaccines for countries that couldn’t afford them.

It’s why HIV experts have been fighting for better access to treatments globally. Particularly since treatments that can control, and even make HIV undetectable have become available.

“If you’re undetectable you can’t pass the virus on. That is stigma bashing news,” AIDS Map’s Matthew Hodson tells What The Pox? “It also is a really powerful call to ensure all people wherever they live in the world, whatever their income have access to treatment. It will not only will save their lives, but it will also and the HIV panademic.”

But despite great progress being made around HIV, Hodson says there are warnings from history – that the fight isn’t over. After all almost a quarter of a century after effective treatments were established, globally, around one in four people with HIV still don’t have access to treatments.

There is also a real danger that monkeypox could become endemic in even more countries without action. Hodson says countries need to “push the buttons” available to them. That means making vaccines and the recipes or patents to them available.

Quotes in this article were edited for clarity. What The Pox? is available in podcast apps.

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