Health

The monkeypox double standard: Public health communication about it differs significantly from COVID-19

During the COVID-19 pandemic, some political leaders like California Gov. Gavin Newsom (D) took drastic measures, even telling churches they were non-essential and needed to close. Now that a monkeypox epidemic is raging, particularly among the gay population, it seems like a double standard.

Public health officials are so concerned about the stigma against gay men that authorities risk harming this very population. Meanwhile, those currently at little or no risk from monkeypox face unnecessary fear of infection.

In an article on his website entitled Reducing the stigma in Monkeypox communications and community engagementthe US Centers for Disease Control and Prevention issued a messaging guideline saying, “Emphasize this everyone can get monkeypox and promote it as a public health problem for all.

However, the risk is not even remotely equal for all people. According to a study published in The New England Journal of MedicineIn the largest study to date, 98% of people infected with monkeypox were gay or bisexual men.

US health officials refuse to classify monkeypox as a sexually transmitted infection, even though monkeypox is primarily transmitted through sex, according to Dr. Allison Arwady, Commissioner of the Chicago Department of Health.

Likewise said Dr. Ina Park, a professor at the University of California San Francisco School of Medicine: “Right now, it behaves very much like an STI, and almost all cases have involved men who have sex with men.”

Instead, the CDC advises the media and others, “Emphasize that monkeypox can be contracted through direct contact with an infectious rash, scabs, or bodily fluids, respiratory secretions during prolonged, personal contact, or through intimate physical contact such as kissing, cuddling, or having sex, touching objects, fabrics.” (such as clothing or bedding) that have previously been in contact with the rash or bodily fluids of a person with monkeypox, been scratched, or bitten by an infected animal.”

The CDC advises creating an “inventory” of possible super-spreader events and venues, such as “massage parlors, spas, saunas, and sex clubs,” but has stopped mandating the closure of those events and venues, in stark contrast to the mandated business and event closures amid the COVID-19 pandemic, though monkeypox is rarely deadly compared to COVID-19, which has claimed millions of lives.

In San Francisco, for example, the epicenter of America’s monkeypox outbreak, city leaders last week refused to cancel the annual “Kink and Fetish” festival, an event that drew thousands of gay men to the city.

The CDC also refuses to advise gay men not to sleep around to reduce transmission, even though the World Health Organization has done just that. Again, it’s in stark contrast to strict CDC mandates during the COVID-19 pandemic to restrict behaviors like church attendance and large Christmas parties.

Health officials say the reason they prioritize avoiding stigma surrounding same-sex intimacy is because it’s insensitive to the gay and bisexual population and because men who feel stigmatized are less likely to seek medical help. But even those within the gay community say health officials who have avoided closures and cancellations that target the most vulnerable community will only end up harming them.

“It was a devaluation of gay men’s lives and health not to warn gay men,” said Dan Savage, a sex columnist cited in the Washington Post who has criticized the public health response to monkeypox. “Now we’re really on the verge of monkeypox becoming endemic in gay communities around the world, and how is that affecting stigma?”

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