Monkeypox (MPV) has been disproportionately impacting the LGBTQ+ community, especially men who have sex with men (MSM), since the first case was officially diagnosed in Michigan at the end of June. As of Sept. 20, we are at 256 reported cases.
While MPV can affect anyone, cases globally as well as in the U.S. and in Michigan have predominately been among MSM individuals.
I’ll start out by stating the obvious: MPV is not a gay disease. Anyone can be exposed and infected from close, personal contact or by touching contaminated items. However, currently in Michigan and nationally, the vast majority of transmission has been from intimate contact within the MSM community. This puts the MSM community at the forefront of the outbreak and most at risk.
As an infectious disease physician, I recognize this outbreak has reminded some people of the negativity surrounding the early days of the HIV epidemic. I recently reread "And the Band Played on: Politics, People and the AIDS Epidemic" by Randy Shilts and it reminded me of the pain and trauma suffered by the LGBTQ+ community. In the words of the author, “what society judged was not the severity of the disease, but the social acceptability of the individuals affected with it.”
We must make sure that does not happen again. We — public health leaders, medical providers and the community at large — must do all we can to combat and reduce stigma and discrimination that may be connected to MPV. We must learn from the mistakes made in the past, by moving toward open and honest communication about disease transmission. This includes nonjudgmental conversations about sex, frank conversations about science and data, with an acknowledgement about what we know and what we are still learning.
There has been debate on the national and international stage about whether to call MPV a sexually transmitted infection. It would clearly be a mistake to say that MPV can only be transmitted through sexual contact, however the data is clear: MPV is transmitted through close or direct contact, which may occur during sexual activities, as well as other non-sexual activities.
Our understanding around this particular strain of MPV will change as time goes on. And we should continue having frank, open discussions about the data as new information emerges, and how best to adapt and interpret our evolving data to best protect our communities.
At this point in time, our most important tools to halting the spread of MPV in Michigan are 1) knowledge about disease transmission and 2) the availability of a safe and effective vaccine.
If you think you may be eligible for vaccination, please make an appointment with your local health department. If you think you have signs or symptoms of MPV, please make an appointment with your health care provider. If you do not have a trusted health care provider, reach out to your local health department for contact information on local providers with familiarity diagnosing and treating MPV.
My personal commitment to the LGBTQ+ community is to be an ally and advocate through the MPV outbreak and any other public health crises that come our way. My colleagues at the Michigan Department of Health and Human Services (MDHHS) and at local health departments around the state stand behind this commitment too. We are stronger together.