With monkeypox, the world must heed the lessons of HIV/AIDS

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Since new outbreaks of monkeypox started making headlines across the world, we have been receiving text messages non-stop. “If I get monkeypox, will everyone know I am gay?” asked one friend in the Gulf. Another who works for an NGO in Lebanon was unsure whether to even share news about the disease, for fear of adding to the already intense stigma experienced by gay people across the country. We applaud the recent statement by UNAIDS denouncing the “racist” and “homophobic” coverage of monkeypox, but much more is needed as a lot is at stake here.

Let’s be clear upfront: monkeypox is very different from HIV/AIDS. But as headlines link the disease to outbreaks among men who have sex with men, the lessons we learned 40 years ago about stigma and infectious diseases have come roaring back to prominence.

As monkeypox moves towards the top of the international news agenda, the world has a small window of time to get it right, and prevent the same mistakes that fuelled HIV/AIDS-related panic, fear and discrimination for over four decades.

So far, we are in danger of failing the test. Unlike 40 years ago, thanks to social media, and 24-hour news coverage, any news about monkeypox travels across the world in the blink of an eye. And for now, news reports on the infectious disease are suggesting a unique association between monkeypox and sexuality, specifically an association between the virus and gay men or men who have sex with men.
Yet there is nothing about the way this viral disease is transmitted that is actually unique to gay men or men who have sex with men. Monkeypox is transmitted through large respiratory droplets via prolonged face-to-face contact, contact with bodily fluids, or contaminated objects or surfaces. These transmissions can occur between any two people – regardless of sexual orientation or gender identity or any other identity.

Media coverage that clouds these simple facts is a threat to everyone. Such coverage causes men who have sex with men to face even more stigma while creating the false impression that everyone else is somehow immune or not at risk. It’s a recipe for disaster.

We have seen all this 40 years ago. Back then, early media reports linking a new infectious disease to gay men raised alarms and fed panic. Soon the disease was given a name rooted in that panic: GRID, or gay-related immune deficiency.

Overlooked were the data and science showing that, while identities may put certain communities at higher risk, it does not mean that the virus infects these communities specifically. In fact, we learned from HIV that the answer is tied closely to conditions in which people are born, grow, live, work and age – such as their financial status, education, neighbourhood and physical environment, employment, and social support (aka social determinants of health) rather than sexual or gender identities.

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