CDC: Consider fewer sexual partners to avoid monkeypox

Monkeypox is not considered a traditional sexually transmitted disease because it is primarily spread through close contact with lesions. However, global data suggests skin-to-skin contact during sex is fueling the outbreak, which has led to more than 7,000 infections in the United States and 26,000 worldwide. Cases reviewed in detail show that infections occur predominantly among gay men.

Last week, the head of the World Health Organization said men who have sex with men should consider temporarily reducing the number of their sexual partners or stopping adding new ones in a bid to contain the outbreak, sparking debate over whether to address calls for sexual restraint are counterproductive and stigmatizing.

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The CDC’s new sexual health guidance echoes WHO Director-General Tedros Adhanom Ghebreyesus’ comments, albeit not as bluntly. Men who have sex with men are not singled out. CDC guidance states that the risk of exposure can be reduced by limiting sexual partners, avoiding spaces such as sex clubs where anonymous sexual contact occurs with multiple partners, and wearing clothing, including leather or latex, as skin-to-skin protection during sex. barrier is worn.

The guidance emphasizes that behavior changes may be temporary until a person is fully vaccinated against monkeypox with two doses. Although the United States is distributing hundreds of thousands of vaccine doses in the coming weeks, there are not enough to vaccinate all beneficiaries and some jurisdictions are only giving out one in two shots to stretch limited supplies.

“These temporary changes will help slow the spread of monkeypox until vaccine supplies are adequate,” the CDC guidance states.

Before the update, the CDC had only advised people with confirmed or suspected cases of monkeypox to refrain from sexual activity.

Health officials generally emphasize ways to reduce the risk of contracting diseases through sex, rather than urging people to avoid sex. Some public health officials and experts say people will make their own decisions to abstain from risky sexual activity when presented with information about viruses and how they spread.

Ask the Post: What are your questions about monkeypox?

Monkeypox has presented public health officials with message delivery challenges because it can be transmitted outside of sexual activities, e.g. B. by hugging or sharing contaminated bedding, and because condoms do not offer complete protection against skin rashes.

Some public health experts say recommending a temporary reduction in sexual activity does not amount to a call for abstinence, which disease prevention specialists widely regard as ineffective.

“It’s not a forever thing. It’s a preliminary matter, and we’re working to expand biomedical interventions,” said Demetre Daskalakis, a senior Biden administration official who is leading the monkeypox response and has expertise in HIV prevention, on a call Friday reporters.

The CDC did not widely promote its new guidance after it was posted online Friday. A tweet and accompanying video referencing the changes made no mention of the new recommendations to reduce exposure, including restricting sexual partners. Daskalakis said officials will reach out to organizations with credibility in the hardest-hit communities to help spread prevention messages.

Although the CDC guidelines make no mention of sexual orientation or gender identity, data released by the agency Friday shows that infections remain predominant in men who have sex with men.

In 358 male cases with detailed information, 94 percent reported having been intimate or sexual with another man in the three weeks before symptoms developed.

Nearly 300 men provided additional information about their sexual activity during that three-week period: 40 percent reported two to four partners, 27 percent reported one partner, 19 percent reported 10 or more partners, and 14 percent reported five to nine partners .

Monkeypox causes flu-like symptoms, including fever, swollen lymph nodes, and a rash that can spread throughout the body. Doctors are monitoring additional lesions around the genitals, mouth and anus of patients suspected of being linked to sexual transmission in the latest outbreak.

In 291 cases with detailed symptom data, 42 percent of patients did not report flu-like symptoms before developing rashes, as is typically seen in monkeypox patients. In a sample with detailed information on skin rashes, almost half reported it on the genitals.

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The CDC data also showed that people of color carry the burden of monkeypox cases at a rate disproportionate to their presence in the general population.

In more than 1,000 cases with reported race and ethnicity, 41 percent were White, 28 percent Hispanic, and 26 percent Black.

Cases are disproportionately affecting blacks as the outbreak grows, from 12 percent of cases between May 17 and July 2 to nearly a third of cases between July 3 and July 22.