Decades of government inaction forcing LGBTQ+ individuals to monitor their health status more closely may have assisted in preventing another sexual health epidemic in the US.

The first case of monkeypox in the US this year was detected on May 18 in Massachusetts. The first case in Iowa was on July 1. Now there have been 24,845 cases in the US and 25 in Iowa, according to the Centers for Disease Control and Prevention.

At the onset of its discovery, the disease, which was declared an international public health emergency by the World Health Organization (WHO), was making headlines daily. But in recent weeks, news has dwindled.

Luckily, the most significant reason right now is “it doesn’t convey urgency” according to Seth Owens, Prevention Navigation Coordinator at the Iowa Department of Public Health.

Who is affected?

According to the World Health Organization, monkeypox is transmitted through close, intimate contact with an infected person, specifically through contact with lesions, bodily fluids, respiratory droplets and contaminated materials such as bedding.

Since it can be spread through close contact, kissing, touching, oral and penetrative vaginal or anal sex with someone who is infectious could spread the disease. Therefore, anyone who has close, intimate contact with someone who has symptoms is most at risk.

However, the majority of cases in the current outbreak are among men who have sex with men, WHO reported on their Questions and answers webpage.

“Given that the virus is currently moving from person to person in these social networks, men who have sex with men may currently be at higher risk of being exposed,” they said.

While men who have sex with men are disproportionately impacted, “the risk of monkeypox is not limited to people who are sexually active or men who have sex with men,” according to WHO.

Owens reiterated that fact.

“There’s nothing about monkeypox itself that is specific to men who have sex with men. That is not the only way that can be transmitted by any means,” he said.

It didn’t just go away

As the number of cases grew, more information regarding vaccines was released. A monkeypox vaccine was already available when the first case in the US was detected and it was gradually delivered across the country.

Nationwide, vaccines were initially made available for people who have been exposed to monkeypox, men who are gay, bisexual or other men who have sex with men, and people with HIV or are eligible for HIV PrEP.

These vaccines were one of the factors at play in cases declining, but those encouraging each other to get vaccinated were the determining factor in decelerating the monkeypox outbreak.

WIRED recently released an article titled “Monkeypox Cases in the US Are Falling. There’s No One Reason Why” which sparked some backlash in LGBTQ spaces.

One Twitter user, @kirkcruz, who is located in Chicago, suggested rewording the headline to “LGBTQ+ folks mobilized & demanded help.”

“We didn’t sit around waiting for the government to get its s— together. We organized vaxx events at our *bars*, we told our friends, many abstained from sex while waiting to get vaxxed. Just like we had to do in the 80s & 90s,” @kirkcruz tweeted.

Since the AIDS epidemic, men who have sex with men have a long history of taking their sexual health into their own hands while the government wouldn’t assist.

Owens said that men who have sex with men are held to a different standard when it comes to their “expected health engagement.” Because of the fear and stigma surrounding HIV and AIDS, men who have sex with men were hyper-alert of taking care of their sexual health.

“[Men who have sex with men] will get tested, generally speaking, in a year or two more than the general population do in a lifetime,” he said.

WHO said that some cases of monkeypox have been identified at sexual health clinics, particularly because monkeypox rashes can resemble some STIs like herpes and syphilis.

“One reason we are currently hearing more reports of cases of monkeypox in communities of men who have sex with men may be because of positive health-seeking behavior in this population group,” they said.

Peer-to-peer communication, previous knowledge about where local clinics are located, and individuals making the effort to get tested were essential in mitigating the spread of monkeypox so successfully, so early on, according to Owens.

Future outbreaks

Currently, Owens doesn’t believe there will be any other big spikes in monkeypox cases, but, of course, there is always the possibility.

“The good news is that the trends we’re seeing overall are that it’s decreasing, which is good, in major areas where it had been going on for a really long time,” he said

What we need to do, he said, is make sure we’re not leaving groups of people behind, like men who have sex with men, when trying to mitigate the further spread of the disease.

“If we hope for that, that’s one thing but if we’re counting on that it’s a different thing. That almost creates conditions where the opposite thing can happen,” he said.

If we treat it like cases will never go up again, but we don’t make efforts to prevent it, another spike could be inevitable.

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