Top health officials say they are trying to limit the spread of the monkeypox virus while preventing stigma against those most affected, especially gay, bisexual and other men who have sex with men, but their messages may be part of the problem, as reported. some lawyers
More than 21,000 people, in more than 70 countries, have contracted the virus, which causes painful sores and blisters among other symptoms. An estimated 98% of confirmed cases are in men who have sex with men.
This week, the head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, warned that stigma “can be as dangerous as any virus and can fuel the outbreak”. At the same time, he urged men who have sex with men to reduce their number of sexual partners or to reconsider having new sexual partners “for now”.
The Public Health Agency of Canada (PHAC), which has reported At least 745 cases since the first two cases were detected in late May, he also urged men who have sex with men to limit sexual partners, especially casual acquaintances.
“I think when we try to tell people, ‘Stop doing this. Stop doing that,’ it doesn’t really work,” Devan Nambiar of the Gay Men’s Sexual Health Alliance in Toronto told CBC News . “It hasn’t worked on any infections.”
Devan Nambiar, capacity development manager for the Gay Men’s Sexual Health Alliance in Toronto, said the stigma of HIV/AIDS remains in place after more than 40 years. (Submitted by Devan Nambiar)
It’s important for people to know risk factors so they can make informed decisions, and to be compassionate and concise in messaging, he said, but not to stigmatize people for their sexual activity and behavior, which gay men, in particular, have endured since the early years of the HIV/AIDS pandemic when the disease was widely considered a “gay disease.”
Lessons learned from that era have been applied to public health care today, but there are criticisms that history is repeating itself with the handling of the monkeypox outbreak.
Some advocates attending the International AIDS Conference (AIDS 2022) in Montreal from July 29 to August 2 say health officials must avoid the perception that a viral threat, such as HIV/AIDS or smallpox, only affects a part of the population.
“[We] experienced this with the HIV epidemic. We certainly saw that with COVID-19. We don’t do that with monkeypox, do we?” said Linda-Gail Bekker, deputy director of the Desmond Tutu HIV Center at the Institute of Infectious Diseases and Molecular Medicine at the University of Cape Town in South Africa and former president of the International AIDS Society, which organized the AIDS 2022 meeting.
Key involvement in combating health threats
The conference returns to Montreal for the first time since 1989, a time when access was limited to drugs that could prolong the lives of people infected with HIV. Most of the people dying of AIDS at the time were gay, bisexual and other men who had sex with men, transgender women and injection drug users.
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Concerns about public health messages around monkeypox
As cases of monkeypox spread around the world, mostly among men who have sex with men, there is growing concern that public health messages aimed at this community have fallen short.
The monkeypox virus, however, is not a sexually transmitted infection like HIV, the virus that causes AIDS; it is spread through close personal contact with someone infected, but also through direct contact with materials that have touched an infected person’s body fluids or wounds, such as bed linens or clothing.
Bekker believes that without proper communication and engagement with affected groups, whether it’s HIV/AIDS or monkeypox, there is a risk of discrimination that can lead to people not seeking or being able to access the services they need.
Gay men take their health into their own hands
Nambiar, who will also attend the 2022 AIDS conference starting Friday, said gay and bisexual men have long been their own health advocates, having to “figure out a lot for ourselves” in cause of “indifference” to the LGBTQ. community
“We’ve actually led the way in a lot of things, in terms of self-policing, taking [on] to stand up for, to take autonomy in terms of our well-being, to fight for our rights,” she told CBC News.
With monkeypox, he said, gay and bisexual men have been vocal from the start, calling for paid leave so they can properly quarantine themselves and demanding access to testing and vaccines.
He said it’s an individual decision to get vaccinated to protect against monkeypox, something about 27,000 eligible people in Canada have done so far, according to PHAC.
Some public health authorities have set up pop-up vaccination clinics in places frequented by men who have sex with men, such as gay bars, bathhouses and cruise lines. The response to monkeypox has been “pretty decent” in Canada, Nambiar said, though he can’t say the same for other countries.
In the United States, which now has the highest number of recorded monkeypox cases, the response to the outbreak has been criticized. An AIDS advocate compared the US government’s initial response to monkeypox to its handling of the COVID-19 pandemic, when the country led the world in deaths and less than 70% of the population was fully vaccinated .
LISTEN | Dr. Anthony Fauci on HIV/AIDS, Monkey Pox and COVID-19:
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HIV/AIDS eclipsed by converging threats
As fears grow over monkey pox and the number of COVID-19 cases rises again, health professionals gathering in Montreal worry about whether the world will be able to reach the UN’s 2030 goal to end HIV/AIDS as a global health problem.
There were an estimated 38.4 million people living with HIV/AIDS worldwide in 2021, with approximately 1.5 million new HIV infections last year. The United Nations said that is one million cases above global targets and a sign of “faltering progress”.
This week, at the presentation of a new UNAIDS report titled At risk, UNAIDS Executive Director Winnie Byanyima warned that “the response to the AIDS pandemic has been derailed by global crises”, including the war in Ukraine and international economic instability.
“The actions needed to end AIDS are also key to overcoming other pandemics,” he said.
During the four days of the AIDS 2022 conference, there will be a push to “counter apathy” in the global fight against HIV/AIDS and a call “to re-engage and follow science”.
UNAIDS Executive Director Winnie Byanyima presents the 2022 Global AIDS Update at a press conference in Montreal ahead of this weekend’s World AIDS Conference. (Ryan Remiorz/The Canadian Press)
“Some of that is going on the offensive,” Bekker said, noting that there is an additional challenge with the polarization around science that has emerged in the COVID-19 pandemic.
Nambiar said part of this apathy toward HIV/AIDS comes from being “inundated with viruses,” with the mutated variants and subvariants of COVID-19, and now monkeypox.
But he said one of the important lessons learned over the years, which certainly applies today, is that a successful response to a public health emergency requires cooperation between governments, health workers public and community organizations. This didn’t happen immediately with HIV/AIDS, but you see it now developing in response to monkey pox.
While there have been remarkable successes in the past four decades in preventing HIV transmission and enabling people to live with infections as a chronic disease, Bekker wants to remind people that this does not mean that the HIV pandemic/ AIDS is over.
“I would say we have the hardest mile to go,” he told CBC News. “We really need to gird our loins, come together as a community and say, ‘What can we do to get to the last mile?’