LGBTQIA+ population sees stigma risk with monkeypox outbreak

In 1981, the arrival of an unknown disease, which mainly affected men who had sex with other men, in California, in the United States, put the world on alert.

There, HIV, the virus that causes AIDS (Acquired Immunodeficiency Syndrome), started what would be the “homophobia epidemic”, says infectious disease specialist Jamal Suleiman, from the Emílio Ribas Institute. The disease came to be called gay cancer.

Since then, 40 million people have died from AIDS-related diseases –such as tuberculosis and viral hepatitis–, according to data from UNAIDS (Joint United Nations Program on HIV/AIDS). In Brazil, about 920,000 people are living with the virus.

The WHO’s (World Health Organization) announcement last July to classify monkeypox as a public emergency of global concern would be serious enough.

However, the addition of information that more than 95% of the cases —15,510 confirmed so far— were among men who had relationships with men, in addition to the recommendation that this population reduce their sexual contact, revived the fear of stigma of 1980s.

Administrative manager Pedro Martins, 25, is suspicious of the WHO guidelines and demands that they also be aimed at the heterosexual population.

Martins says he was always careful and nothing changed in his sex life. “Again, they treat a disease like the gay plague, as they did in the 1980s. [homens LGBTQIA+] do we need to cut down on our sexual partners? And the guidelines for straight people? That’s a mistake, everyone has sex,” she says.

To the report, two other men who claim to have sex with other men share the opinion about the disease being labeled. They claim that they continue to have several partners, in addition to going to clubs and “darkrooms” (dark environment where regulars have sex), but they have talked about the disease before dating.

Unlike AIDS, monkeypox is not sexually transmitted. Its main form of propagation is skin-to-skin contact with the vesicles that the patient has. As intimate contact is more recurrent in sex, transmission is easier to happen.

Official for Communities, Gender and Human Rights of Unaids Brazil, Ariadne Ribeiro says that the AIDS pandemic brings a strong lesson of the importance of not stigmatizing people or social groups for the vulnerability they may have, initially, to a certain epidemic outbreak.

“When the first cases of AIDS appeared, there was still little knowledge about how it spreads, which generated a mistaken approach aimed at risk groups. This approach not only stigmatized these groups, but also gave the illusion that the rest of society would not be affected, an easy lie to accept”, declares Ribeiro.

The UNAIDS representative emphasizes that, in the case of monkeypox, there is attention to the risk of stigmatization, in addition to a highly mobilized civil society to prevent the same mistakes of the past from being repeated.

Jamal Suleiman says he sees many similarities between the treatment given to HIV in its early days and the treatment given today to monkeypox, the virus that causes monkeypox.

“It is easy to blame the most vulnerable, a mistake that we cannot allow to be repeated. The price is too high to remove this stigma later”, adds the infectologist.

Like Unaids, he claims that only assertive communication about prevention can work in combating the disease.

“The virus does not choose a community, it chooses behavior. You can’t cover the sun with a sieve, we have to talk about and for whom, today, it is most vulnerable. But it is important to emphasize that behavior cannot be criminalized, no one is a fiscal of morals. It’s a matter of health, not judgment.”

The doctor from Instituto Emílio Ribas attended during the HIV/AIDS epidemic and currently takes care of patients with monkeypox. “It’s a boring, painful and limiting disease.”

Gay, student Lucas Vasquez, 24, trusts the way the disease’s progress has been portrayed and the WHO’s guidelines.

“I think the reaction of the LGBTQIA+ community is disproportionate. It’s as if it were a lie that a part of it is inconsequential. You shouldn’t defend the right to contamination. I believe the WHO just wanted to understand how things are happening”, says Vasquez. Despite this, he claims that nothing has changed in his sex life, which he considers moderate.

With the spread of contamination around the world, Grindr, a dating platform aimed at the LGBTQIA+ male population, has alerted its users to the risks of physical contact in the spread of monkeypox.

According to the portal Our World in Data, from the University of Oxford, until last Friday (5), 27,562 cases of monkeypox had been confirmed in 83 countries, in addition to nine deaths. In Brazil, the Ministry of Health confirmed 1,369 cases until last Monday (1st). About 75% of those infected are in São Paulo, where one person died.