Talking about monkeypox? Then you should be talking about sex
JUANA SUMMERS, HOST:
The people currently most affected by monkeypox are still overwhelmingly men who have sex with men. That's according to the World Health Organization. And that has caused some hurdles when it comes to public health messaging about the virus. Everything from its name to promoting ways to stop the spread of monkeypox can further stigmatize gay and bisexual men. But as NPR's Andrew Limbong reports, a few experts have ideas about why it's important to keep sex front and center in the monkeypox conversation.
ANDREW LIMBONG, BYLINE: On the CDC website, where it talks about monkeypox prevention, there's now a section dedicated to safer sex during monkeypox. But it doesn't specify that men who have sex with men are currently at the center of the outbreak, which it should, says Chris Beyrer, epidemiologist and incoming director of the Duke Global Health Institute.
CHRIS BEYRER: You have to be specific about who's actually at risk and what are the transmission routes and the exposures - at the same time, not wanting to stigmatize that community.
LIMBONG: Now, you can get monkeypox in other ways besides sex, such as touching fabrics that have been used by someone with monkeypox - so towels or linens. But the evidence so far suggests that that's extremely rare. Beyrer says one of the biggest public health challenges is around limiting risky behavior involving sex - so advising queer and gay people to reduce the number of sexual partners and avoid close contact with people you don't know - the exact type of messaging that harkens back to the early days of the HIV crisis.
BEYRER: And a lot of people found it to have some kind of elements of homophobia and, you know, to be anti-sex when, you know, sexuality is a very big part of identity.
LIMBONG: Jennifer Brier is a historian of HIV/AIDS at the University of Illinois, Chicago. And she points back at one of the formative texts of public health - a booklet published in the '80s to make up for an absolute lack of government response to the crisis. It's by writers Michael Callen and Richard Berkowitz, titled "How To Have Sex In An Epidemic." The booklet first started as a screed titled "We Know Who We Are: Two Gay Men Declare War On Promiscuity."
JENNIFER BRIER: And people went banana pants at that article - I mean, just bananas. Like, you're attacking gay liberation. That's who we are, right? And I understand that at some level. But they were also trying to figure out a model of harm reduction before it existed.
LIMBONG: And it's a playbook people are still learning from today in dealing with the monkeypox outbreak. Nick Diamond is a co-investigator with RESPND-MI, a community-led effort to anonymously collect data on sexual networks among queer and trans people in New York City. And in July, he wrote a document called "Six Ways We Can Have Safer Sex In The Time Of Monkeypox."
NICK DIAMOND: I'll be the first to say that we have been leaning on activists from the AIDS response to develop these actions and these organizings around our response to monkeypox.
LIMBONG: But he adds that it's an imperfect line to draw. HIV/AIDS was a much deadlier disease, and it existed at a much more different time politically. And yet, Diamond says, people still have a hard time talking about queer and trans sex.
DIAMOND: And we have to talk about sex when we're talking about monkeypox. I think that these are uncomfortable conversations, but it is one of the determinants of our health and rights. And so I think if we're going to have a comprehensive response, we need to talk about sex.
LIMBONG: While men who have sex with men are currently at the center of the monkeypox outbreak, HIV/AIDS historian Jennifer Brier says that specific turn of phrase can be limiting.
BRIER: Our sexual desire and our sexual practices are way more complicated than any phrase can give us.
LIMBONG: All the more reason why it's important to talk about it. Andrew Limbong, NPR News.
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