Marco, 40, lives with his partner in Edmonton, Alberta. Marco’s partner has been feeling “flabby” for a few days – low fever, some tiredness and a couple of small bumps on his hands which he didn’t give much thought to as they didn’t look serious.
Marco joked with him and suggested it might be monkeypox. “I mean, what are the odds? Like 1 in 6 billion?” he told BuzzFeed News.
At that time, there was only one confirmed case of the monkeypox virus in all of Alberta.
The next day, Marco’s partner received a call from a public health nurse who informed him that he had been in close contact with a person who had tested positive for monkeypox. Marco also spoke to the nurse and told her he was fine, but he had what looked like a cancerous growth under his tongue, only it wasn’t particularly sensitive.
“I just had tacos with Valentina sauce on them, and it didn’t hurt at all,” he said. (The hot sauce would burn most canker sores.) The nurse assessed their risk and symptoms and asked both of them to come in for testing immediately.
Two days after getting tested, Marco and his partner received another call from the public health nurse. “I just got the call that we’re both positive for monkeypox,” he told BuzzFeed News on Wednesday.
Monkeypox is still relatively rare, but cases are increasing
A new outbreak of monkeypox is spreading across the US, Canada and Europe, and many of the early cases have affected queer men. According to the World Health Organization, there have been about 1,200 cases of monkeypox worldwide as of June 8, including 321 in the UK, 100 in Canada and 39 in the US. Fifteen different states have had cases, including California, New York and Florida.
There is cause for concern, but this is not another COVID. The virus is not as contagious and not as easily spread, and two monkeypox vaccines already exist. One is Jynneos (also known by the brand names Imvamune or Imvanex) and the other is ACAM2000. They can help prevent symptoms even after exposure or infection.
While about 3% to 6% of people with monkeypox can die from the infection, which is more dangerous in children and people with compromised immune systems, the strain of the virus currently spreading appears to be milder, similar to that endemic to West Africa. A more dangerous strain of monkeypox is endemic to central Africa.
The events come as Pride events are underway in many cities. People are traveling and partying at what for many is the first summer since 2019 to finally be able to gather free from COVID restrictions. Masks are no longer compulsory on public transport or in many cities. Because the virus can be spread through close contact, health experts are on high alert and working quickly to educate LGBTQ+ communities about STDs.
But to be clear – monkeypox is not technically an STI, although some people report having lesions on their genitals or getting the virus during sexual contact. The disease can be spread through any type of close or physical contact, including cuddling and kissing, sharing towels or sheets, or even breathing secretions from breathing or talking during prolonged face-to-face contact – so wearing a mask can help stop the disease from spreading Virus.
Monkeypox is not a new disease. It was first discovered in monkeys used for scientific research (hence the name) in 1958 and first observed in humans in 1970. In places where it is endemic, it circulates naturally in animals such as rodents and occasionally jumps to humans who handle, are bitten or scratched by infected animals.
Cases are uncommon outside of Africa or in people who have not recently traveled to an endemic area, although there was an outbreak in the US Midwest in 2003. In this case, 70 people contracted the virus from prairie dogs kept with imported rats and dormouse.
In general, monkeypox symptoms include fever, headache, muscle aches, back pain, swollen lymph nodes, chills, and fatigue. Symptoms usually appear 7 to 14 days after exposure but can appear anywhere from 5 to 21 days. About one to three days after symptoms begin, sufferers generally develop rashes and raised lesions that eventually crust and form scabs that fall off. Overall, the symptoms can last up to four weeks.
Marco has noted that his and his partner’s symptoms differ from what he has read on health authority websites.
“You know how when people get symptoms they go to Dr. Go Google,” said Marco. “And you see the signs and symptoms, but nobody says the signs and symptoms can vary.”
People infected with monkeypox may have a rash that begins on the face before spreading to other parts of the body, according to the CDC.
Marco noted that neither he nor his partner developed a rash. “The rash should turn into pustules all over the body,” said Marco. “Neither has it happened to us, except maybe under my tongue.”
Monkeypox is not a “gay disease” and the potential for stigma is a concern
Marco asked us to only use his first name to avoid possible stigma of the diagnosis for him or his partner, but he also wanted to share their experience to prevent further spread of the virus.
Stigma is built into the LGBTQ+ experience.
HIV/AIDS has been closely associated with queer men since the outbreak of the epidemic in the 1980s. Some worry that monkeypox will follow the same path. This year, UNAIDS, the international HIV/AIDS organization, released a statement on the stigmatizing effects of mentioning monkeypox to LGBTQ+ people and Africans in public communications.
Aside from causing social harm, UNAIDS also warned that such associations could lead to further public health problems. The program’s Deputy Executive Director, Dr. Matthew Kavanagh said in the press release: “Stigma hurts everyone. Shared science and social solidarity help everyone.”
Others say worrying about stigma is less important when it comes to public health. Historian Jim Downs recently wrote an article for The Atlantic entitled “Gay Men Need Special Warning About Monkey Pox.” In that article, Downs writes, “Providing carefully tailored warnings to gay men about the risk of monkeypox can be a form of education, not a form of stigma.”
Peter Staley, one of the founding members of the HIV/AIDS activist organization ACT UP, agrees. He said queer men will always face stigma, whether through rhetoric surrounding monkeypox or otherwise.
“The right will attack us with anything and everything they can. They always have and they always will,” he told BuzzFeed News. “We should never let that dictate how gay men talk to each other about health and risks.”
Staley fully acknowledges that communicating the risk of monkeypox raises the possibility that the wider public could associate the virus with queer men, thereby creating stigma.
“You have to fight two battles at the same time. We need to target gay men through targeted messages. And we must be ready to fight the resulting stigma by delivering messages that are tailored to the general public.”
Just weeks after the first US case was reported on May 19, targeted news about monkeypox is already reaching queer men across the country. Such agile communication is possible through existing infrastructures that have been paved by campaigns to reach out to LGBTQ+ people for the prevention of HIV/AIDS and other STIs.
With June being Pride Month, the CDC acted quickly and appointed its Director of HIV/AIDS Prevention, Dr. Demetre Daskalakis, dispatched to work with organizations and health groups to spread the word about monkeypox. He and his team plan to speak to several Pride organizers this week. Daskalakis said the gatherings this summer can be seen as an opportunity rather than a risk.
“I believe that Pride is an excellent opportunity to educate people. And thinking about our advice, it’s really about giving people the knowledge they need to navigate events that can happen throughout the summer, whether they go to Pride or not,” he said BuzzFeed News. “I tend not to think of places as risky environments because it’s really about mitigating your risk, having the right information to navigate what you’re willing to do.”
Daskalakis believes this outbreak of monkeypox bears more resemblance to an outbreak of MRSA, an antibiotic-resistant staph infection, in 2008 than to the HIV/AIDS pandemic that began in the 1980s. The so-called flesh-eating bacteria first spread among groups of queer men before spreading to the general population.
“It’s similar to being spread through very close contact. Of course, sex could be a reason for close contact or other intimacy,” Daskalakis said.
Then as now, agencies issued similar alerts from healthcare providers, particularly those that focused on HIV/AIDS and had more queer clients. That was before the advent of smartphones and location-based dating apps. Now the conversation has widened.
Grindr, the most popular of these apps, has issued several informational alerts about monkeypox. The app blasted the inbox of every user in the US, Canada and most European countries with a message written by a local health authority and a link to more official information from a source in their country.
“We’re not a public health agency, but we’re an excellent connective tissue,” said Patrick Lenihan, vice president of communications at Grindr. “Our users want this information, and these groups want to spread it to protect this demographic.”
In the US, Grindr works with a group called Building Healthy Online Communities, which aims to provide targeted messages about sexual health by bringing together public health professionals and dating apps. The app has connected with the Public Health Agency of Canada to send alerts to its users.