The antigay stigma surrounding monkeypox | Opinion | dailyuw.com – Dailyuw
After over two years of social distancing and mask wearing, people around the world thought they could breathe easily again. Although monkeypox has not reached pandemic status, it has sparked fear in the American public, particularly for men who have sex with men (MSM).
Monkeypox was declared a public health emergency Aug. 4, and has infected 27,317 people in the United States. Washington state has had 628 of these cases.
Monkeypox is spread through skin-to-skin contact and can be transmitted sexually, although it is not officially classified as a sexually transmitted infection because it is not spread exclusively through sexual contact. Monkeypox can affect anyone, but it has primarily been infecting MSM.
Many MSM infected with or at risk for monkeypox have faced similar discrimination and violence that members of the community faced during the HIV/AIDS crisis in the late 1980s and early ’90s.
Homophobia-driven hate crimes this past summer in Washington, D.C. were motivated by monkeypox — just one display of the parallels between HIV/AIDS and monkeypox stigma.
Part of the reason that so many MSM died (and continue to die) from complications from HIV is due to the rampant homophobia associated with the disease. HIV was first discovered in MSM in New York and California in 1981 and continued to spread quickly in the MSM community throughout the ’90s.
MSM were at higher risk for HIV when the epidemic began and continue to have the highest rates of any community in the United States. Some of the major factors contributing to the disease’s unequal spread are MSM’s smaller pool of sexual partners and the fragility of rectal tissue. Once HIV spread through the MSM sexual network, it stayed there.
“Contained sexual networks, as well as a climate of sexual permissivity is what allowed HIV to take root,” Dr. Adrienne Shapiro, assistant professor in global health and an infectious disease clinician said. “A tremendous amount of stigma, anti-gay violence, and anti-gay political agendas is what truly allowed it to spread and proliferate.”
Those who are immunocompromised, which is a symptom of HIV, are at higher risk for monkeypox than the general population. This may be another reason why monkeypox has spread quicker through MSM than other communities.
But why do MSM have more sex than other populations?
John Romano-Olsen, a queer third-year student at UW, explained that gay men often turn to sex as a form of coping with the stigmas they face.
“[There is] hypersexualization within the gay community of itself,” Romano-Olsen said. “There are impressionable youths who are discovering themselves as a person and their identity, and they are … not taught about gay sex, they’re not taught about HIV … that plus them having to hide their identity… causes [them] to sort of like have more sex.”
Homophobia associated with HIV in the 1980s did not help to decrease the spread of the disease.
“[There was] the thought that many people had, that [HIV] was like a punishment from God for gay men,” Romano-Olsen said.
The monkeypox outbreak, like the COVID-19 pandemic, has revealed racial inequities within the health care system.
Once white MSM had received their doses of TPoxx, an antiviral used to treat monkeypox, the resources moved away from MSM of color.
This unequal distribution of resources continues to disproportionately affect men of color living with HIV. As of 2020, the Centers for Disease Control and Prevention (CDC) states that Black and Hispanic MSM have more cases of HIV combined than white MSM, despite being a smaller proportion of the United States population.
Racist practices in the medical community may also have contributed to the spread of monkeypox in the first place.
“Monkeypox is not a brand-new disease … It’s been causing morbidity and even mortality in Sub-Saharan Africa for decades,” Shapiro said. “Scientists there have been ignored in calls for more research and testing and clinical attention … It remains critically important for the next virus to be paying attention to other parts of the world where people don’t have as much of a voice.”
After peaking in early August, monkeypox cases are on the decline in the United States.
Seattle has also seen a significant drop.
“It’s likely a combination of behavior change, vaccination … as well as some natural immunity,” Sharon Bogan, communications specialist at Public Health — Seattle & King County, specializing in monkeypox, said.
The similarities in trends between HIV and monkeypox are not all negatively skewed. The network of sexual health care that developed during the HIV epidemic has served as a valuable resource for those looking for medical support with monkeypox.
“Health care that emerged to fill a gap in the setting of [HIV] … ended up being the first point of call for a lot of people to receive care with monkeypox,” Shapiro said.
We can say that we have learned from HIV, and now monkeypox, to better understand the harms of stigmatizing disease. These claims are baseless, however, if minority populations continue to suffer at the hands of social ostracization and medical discrimination.
Reach writer Katie Newman at opinion@dailyuw.com Twitter: @katieinewman
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