We need to have a tough conversation about monkeypox. For the record, this isn’t easy, and it’s not exactly one I’m excited to have. That said, let’s talk about monkeypox nudging closer to being called a sexually transmitted infection, or STI.
There was some big stuff that happened recently that propelled this conversation forward.
Before we go too much further, remember: nuance, context, gray areas.
That’s what we are living in here. There’s no hard and fast, cut and dry answers when it comes to potentially having to classify this as a sexually transmitted infection.
No knee jerk reactions. OK?
The science is evolving. What we are learning is evolving.
A couple of really smart physicians published this on Medium a couple of days ago about monkeypox as a possible sexually transmitted infection. The report said, in part …
“Taken in context, the temporal and anatomic association with various sex practices, the high prevalence of sexual risk behavior among patients with human monkeypox, and the in vitro infectivity of human monkeypox DNA isolated from semen strongly suggest that human monkeypox is transmitted through sexual activity.”
Why is this important?
What does this mean?
Calling this an sexually transmitted infection could (and probably will) have a huge impact on worsening the stigma of gay, bisexual, and other men who have sex with men that is already there.
At the same time, we, including public health and medical professionals, have to pay attention to where the science and the data are leading us to stop this thing, which is obviously already out of control thanks in no small part to an egregiously slow response from governmental public health agencies early on. That’s a different conversation. I digress.
Part of where the science is leading us is understanding that outside of prolonged skin to skin contact, there MAY be a function of increased transmission of human monkeypox through bodily fluids that are only exchanged during sex.
So it’s not just a matter of semantics, but this human monkeypox virus might be different from previous strains of monkeypox. It may be showing different modalities of transmission, which include transmission specifically through bodily fluids exchanged during sex.
It’s something of a scary thought, but also one that we need to start talking about openly so that the stigmatized conversation can get fixed rather than ignored.
It also probably means we have to bring a little more importance to harm reduction initiatives.
We can’t tell our community to simply stop having sex. That’s not going to happen. Preaching abstinence as a public health policy simply doesn’t work, increases stigma, and has all sorts of unintended consequences.
But we can educate people about a greater risk of this virus through sexual activity than we previously thought.
There are some ways for you to mitigate your risk, including, if you can, back off the sex for a little while.
But, if you can’t, there are some ways you can go about having sexual encounters, sexual networks, that are much safer and will mitigate your risk, the risk to others, and the risk of passing human monkeypox forward.
This column is part of an on-going health series from Dr. James Simmons. He will offer useful news and tools that will help empower LGBTQ+ readers to make informed choices about their health.
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