Monkeypox: Expert explains why it isn’t a ‘gay disease’ and warns of risk of stigma

The monkeypox virus under a microscope.

There has been a great deal of panic about monkeypox in recent days as health officials confirm more and more cases.

That concern is understandable – up until now, monkeypox has primarily spread in parts of Africa, but in recent weeks, it has been spreading in communities in the UK, Spain and Portugal.

According to the UK Health Security Agency (UKHSA), gay and bisexual men have so far been disproportionately affected. That fact alone has led to heightened panic within the LGBTQ+ community, with many worried about contracting the virus.

Many others are worried about the prospect of monkeypox being seen as a “gay disease” – LGBTQ+ people who remember the early years of the AIDS epidemic will know too well that a rapidly spreading virus can be used as a weapon against marginalised communities.

That’s why it’s so important we avoid stigmatising LGBTQ+ people in the way we talk about the virus, according to Mateo Prochazka, an infectious disease epidemiologist with the UKHSA. He’s also a gay man living in London, which gives him a unique perspective on the unfolding situation.

Monkeypox discourse could easily become ‘homophobic’

“I’m so concerned that the discourse around this infection is going to become more prevalent and intersect with discourses that are homophobic, especially with Pride season just around the corner and what it means for us as a community,” Prochazka tells PinkNews.

Right now, experts are still trying to figure out exactly why it is that monkeypox appears to be spreading among queer men. There is no evidence to suggest the virus is sexually transmitted, but that misconception is already rife among many people because of the way media outlets are reporting on the unfolding situation.

Experts believe monkeypox is in fact spread through close contact with infected skin. So, while it’s not a sexually transmitted infection, it can be spread during sex via close contact. That’s an important distinction, Prochazka says.

“Gay and bisexual men usually have larger numbers of sex partners and are more likely to have anonymous sexual partners as well, and this can lead to direct contact that may not be seen in other sexual networks with the same frequency,” he explains.

There is a huge risk of stigma emerging and being attached to the current patterns of transmission we’re seeing for monkeypox.

“It might be that the pathogen has now entered those networks and is being spread that way. It does not mean that gay or bisexual men are doing anything inherently wrong, or that the virus has changed or that it’s sexually transmitted, it just means that this behaviour facilitates transmission in these networks.”

Because there’s already so much stigma around sex, that discussion could easily lead to monkeypox becoming seen as a sexually transmitted infection associated with queer men. The UKHSA is already undertaking activities to ensure stigma is stopped in its tracks.

“There is a huge risk of stigma emerging and being attached to the current patterns of transmission we’re seeing for monkeypox, and that will be stigma directed at the infection of gay and bisexual men and sex in general,” Prochazka says.

That’s why it’s so important the right language is used when talking about the virus. Nobody should tolerate monkeypox being referred to as a “gay disease” or any similar euphemisms.

That discourse is also problematic because it could give non-LGBTQ+ people the incorrect impression that they’re not at risk of contracting the virus.

“We wanted to make sure people understand that transmission is not exclusive to gay and bisexual men, it just happens that it has entered this network,” Prochazka says.

LGBTQ+ people are being urged to stay calm while keeping informed about risks

Prochazka and his colleagues are also keenly aware just how much worry is spreading among LGBTQ+ people right now because of the virus. The shadow of HIV and the impact of that stigma still hangs over the community, and in addition to that, people are still working through the trauma and anxiety that came with COVID. The message from experts is clear: everyone needs to stay calm.

“I think health related anxiety is unfortunately a consequence of the intense messaging that sometimes society generates around outbreaks and pandemics,” Prochazka says.

“We’re on the back of COVID-19 and people’s anxiety has also increased because of that experience. I think we need to find a balance between being informed and being scared and that can be done with the right amount of information from correct sources which is what we’re trying to provide. I think knowing this is an infection that has a very low risk for your own personal health and that we’re all trying to control as a community is very important.”

We don’t want to ask people to have less sex or to change their relationship around sex because there’s a context and a history to that.

It’s also worth noting that monkeypox is not nearly as transmissible as some other viruses. Prochazka says you need “direct and prolonged contact” with a person in order to contract the virus.

“That’s how we believe people are acquiring the infection. There’s definitely considerations to have around that, we don’t want to ask people to have less sex or to change their relationship around sex because there’s a context and a history to that, but we want people to be aware this is happening and to be signposted to the right services.”

If you think you have symptoms associated with monkeypox, Prochazka says you should call 111 or your local sexual health clinic if you’re in the UK.

“Remember that at this stage the numbers are still very low, we don’t really understand or know the extent of transmission, so we’re working really fast to do that assessment so we can communicate it to the public.”

The most important thing is that as a community, we’re having open and honest conversations about monkeypox – and it’s vital we talk about the virus in a sex positive way while acknowledging some of the facts around transmission.

“I think it’s so important that we’re having open conversations, remaining sex positive, but also aware of the risks related to our behaviour so we can go to services if we think we are presenting with any symptoms,” Prochazka says.

“It’s just a matter of not turning a blind eye but actually being involved and engaged with this that will help us deal with and tackle any emerging stigma.”

Read our full explainer about monkeypox here.