Do Gay Men Need a Specific Monkeypox Warning?

A disproportionate number of cases in the recent monkeypox outbreak have shown up among gay and bisexual men. And as public-health authorities investigate possible links to sexual or other close physical contact at a Pride event in the Canary Islands, a sauna in Madrid, and other gay venues in Europe, government officials are trying hard not to single out a group that endured terrible stigma at the height of America’s AIDS crisis.

“Experience shows that stigmatizing rhetoric can quickly disable evidence-based response by stoking cycles of fear, driving people away from health services, impeding efforts to identify cases, and encouraging ineffective, punitive measures,” Matthew Kavanagh, the deputy executive director of the Joint United Nations Programme on HIV/AIDS, recently said. For many years, following the outbreak of HIV, the fear of being judged or shamed has dissuaded some gay men from being tested.

But as a gay man who studies the history of infectious disease, I worry that public-health leaders are not doing enough to directly alert men who have sex with men about monkeypox. Gay men are not the only people at risk, but they do need to know that, right now, the condition appears to be spreading most actively within their community. In recent days, CDC officials have been acknowledging this forthrightly. Director Rochelle Walensky noted Thursday that, of the nine monkeypox cases identified in the United States as of midweek, most were among men who have sex with men.

Yet many other well-intentioned officials appear fearful of saying something homophobic, and news outlets have published articles emphasizing that monkeypox is “not a gay disease.” Their caution is warranted, but health agencies are putting gay men at risk unless they prioritize them for interventions such as public-awareness campaigns, vaccines, and tests.

Monkeypox, which is related to smallpox and causes symptoms that include a rash, had not previously been viewed as a sexually transmitted infection, but many people who have contracted the disease recently have exhibited symptoms, such as lesions around the genitals or the anus, consistent with sexual transmission. Public-health officials need to work with gay-community health centers and other LGBTQ organizations to deliver information about monkeypox symptoms to doctors and their patients.