Can America Apply Lessons from HIV/AIDS Crisis to Deal with Monkeypox?
As known cases of monkeypox in the United States, the vast majority of which are among gay and bisexual men, continue to increase, an argument is raging – in the news media and on Twitter – over how to talk to the public about the disease. Some want to emphasize that “everyone is at risk,” which is technically true. Others argue that because gay and bisexual men are the ones getting sick with monkeypox right now, they need to be the focus of messages about the disease.
People in both camps point to the history of HIV/AIDS to bolster their claims, and both raise valid concerns. Those in the “everyone is at risk” camp are concerned about sexual freedom and the real threat of right-wing attacks on queer people. For example, Alejandra Caraballo, a clinical instructor at Harvard Law School, warned on Twitter that a focus on gay men by health officials is fueling anti-gay rhetoric on the far right. “Given the climate in the US,” she wrote, “this will lead to a dark place with rampant homophobia resulting from this. We have learned nothing from HIV/AIDS.”
Those in the opposing camp argue that public health officials have learned from HIV/AIDS, but that they’ve learned the wrong lessons. This group includes some gay men, such as science reporter Benjamin Ryan and epidemic disease historian Jim Downs. The history of HIV/AIDS looms large for this group as well. Ryan compares official messaging on monkeypox to the federal government’s America Responds to AIDS campaign of the late 1980s, which informed Americans that “anyone can get the AIDS virus.” This slogan, he argues, “belied the truth about the relative risk of HIV, which in Western nations has always predominantly affected gay and bisexual men.”
Again, neither side is wrong, strictly speaking. AIDS researchers initially contribtued to public homophobia by referring to AIDS as “gay-related immune deficiency,” as though the very fact of gay men’s sexual identity was responsible for the epidemic, and the designation of Haitians as an additional “risk group” fueled a wave of discrimination and violence against them. And campaigns like America Responds to AIDS, which launched in 1987, six years after doctors first recognized the disease in communities of gay men, suggested that HIV was only a problem insofar as it threatened straight people. In that light, saying that “everyone is at risk” can feel like a well-intentioned attempt to paper over the very real effect that monkeypox is having on gay and bisexual men.
But the discussion about whether to talk about monkeypox in terms of gay and bisexual men’s risk ignores racial inequities within gay communities. In fact, one of the most important lessons to learn from the history of HIV/AIDS is that we can’t treat gay and bisexual men like a monolith. Instead, we need messages, along with prevention and treatment programs, that are created with Black and brown gay and bisexual men in mind if we’re going to stop monkeypox from becoming endemic in communities that are already vulnerable to epidemic disease.