Not a ‘gay disease:’ Monkeypox can affect anyone, advocates say — here’s how to avoid it

Daniel J. Downer, an advocate for Black and Brown LGBTQ social issues in Central Florida, has been increasingly concerned by the messaging he’s seen about monkeypox.

He’s noticed it focuses heavily on telling men to stop having sex with men.

“This isn’t a gay or queer disease specifically,” he said. “It’s not only transmitted through sex. Unfortunately, I think … public health officials have made a serious misstep with just putting so much focus on that.”

Monkeypox can infect anyone. It spreads through close, skin-to-skin contact with an infected person’s rash or bodily fluids, or uncleaned surfaces that their rash has touched, the Centers for Disease Control and Prevention says.

It’s existed for decades but recently spiked worldwide, causing rashes that can look like pimples or blisters, and sometimes flu-like symptoms. Though painful, it’s rarely fatal, the CDC says.

The current outbreak was first identified in men who had sex with men, and the majority of the people currently diagnosed are members of that community, according to the CDC. However, that doesn’t mean it originated there or that it can’t impact other communities as well.

Two U.S. children have been diagnosed with monkeypox, CDC health officials have shared.

“Calling monkeypox a gay disease, I think, is blatantly stigmatizing and incorrect,” said Dr. Jonathan Appelbaum, a practicing physician and chair of the Department of Clinical Sciences at Florida State University.

As the disease spreads, so does stigma. NBC news reported Wednesday that a group allegedly attacked a gay couple on a Washington, D.C. street: the suspects mentioned monkeypox and yelled an anti-gay slur. In many countries, being gay is illegal or incites violence. Bloomberg News reported that in India, cases are being undercounted because queer men with monkeypox are scared to get tested for fear of being outed.

Meanwhile, some health officials continue to insist that the virus isn’t a concern to people outside the gay community.

Florida Department of Health spokesperson Jeremy Redfern on Aug. 4 mocked Florida school boards who wanted guidance on how to minimize risk to their students.

“We are now getting requests for monkeypox guidance from school boards. Guys… c’mon,” he tweeted. “@FLSurgeonGen and @HealthyFla [FDOH and State Surgeon General Joseph Ladapo] isn’t going to let you put masks on kids for a disease that is almost exclusively spreading among adult men through sexual contact.”

The CDC is not currently recommending masks for this virus because the agency has not linked any cases in this outbreak to airborne transmission.

Downer believes public health officials, media and politicians would have a less stigmatizing message and perhaps even do a more effective job curbing spread by focusing less on the group that is currently infected and more on the way monkeypox spreads, and how to avoid it.

“Heterosexuals, they kind of feel like ‘oh, well, this doesn’t impact me,’ and then three, six months from now, we may have an increase of it within the heterosexual community, and folks are like, ‘Wait, why is this happening? Because we thought that this only found in this community,” said Downer.

Similar concerns about stigma have come from the name “monkeypox.” The World Health Organization has agreed with scientists who called the name stigmatizing. Critics point out there’s a long history of Black people being called “monkeys,” and this is perpetuating the idea that people in Africa are somehow to blame as well as falsely implying monkeys can only transmit the disease.

Compounding the need for more education about prevention is that as monkeypox bleeds into the general population, even the community first affected is struggling to protect themselves.

George A. Wallace, executive director of The LGBT+ Center Orlando, a hub for Orlando’s LGBTQ community, is having a vaccination event on Saturday: all 96 slots were filled just 17 minutes after it opened up for appointments, Wallace said, and he’s not sure when he can host another event.

“We’re at the mercy of when the vaccinations are available,” Wallace said.

The Biden Administration has come under sharp criticism for being slow to order vaccines for the current outbreak, which has resulted in demand outstripping supply for the near future in the state and in the nation, the New York Times reports.

Downer said he found out about the shots from friends, not the Florida Department of Health in Orange County. The department, which initially did not advertise the shots, now has appointments on orange.floridahealth.gov with a strict list of what makes people eligible.

“As a queer man living in Central Florida … all we’re hearing is, you know, this is something that impacts your community very heavily,” Downer said. “Oh, but by the way, you can’t get vaccinated unless you’ve been [doing] this, this, this, and this.”

Relevant precautions could include using hand sanitizer and disinfectants, learning what the rash looks like, checking for it even in hard-to-see places like the mouth throat or genitals, and avoiding contact with someone with a rash, the CDC says.

Beyond the vaccine, the CDC recommends limiting sexual partners; checking for new or unusual rashes and exchanging contact details with any sexual partners, whenever possible.

Kissing, if a mouth has sores, can also spread the virus, says the CDC. Going out to a club or party where there is minimal clothing could spread monkeypox; it’s wise to avoid rashes and consider wearing more clothing or minimizing skin-to-skin contact, its website says.

Appelbaum thinks another missed opportunity comes when officials emphasize that monkeypox spreads through sexual contact without focusing on how it spreads.

“When we talk about sexually transmitted infections, we talk about using barrier methods like condoms, and that may not work — in fact, it’s unlikely to work — in monkeypox,” he said.

He worries calling it an STI is misleading and may make people think it can only spread through sex.

“I think the message to everyone needs to be avoiding … direct contact with people, particularly if they have any symptoms,” he said.

There’s considerable debate among doctors and health officials about whether it should be considered an STI, however: The Florida Department of Health, in its eligibility screening questionnaire for monkeypox vaccines, asks if gay men have been diagnosed with “another” sexually transmitted infection in the last two weeks.

ccatherman@orlandosentinel.com; @CECatherman Twitter