Monkeypox is not considered a traditional sexually transmitted disease because it is mainly spread through close contact with lesions. But global data suggests that skin-to-skin contact during sex is fueling the epidemic, which has led to more than 7,000 infections in the United States and 26,000 worldwide. The cases that have been examined in detail show that the infections mainly concern homosexual men.
Last week, the head of the World Health Organization said men who have sex with men should consider temporarily reducing their number of sexual partners or stopping adding new ones to help stem the tide. epidemic, sparking a debate over whether calls for sexual restraint are counterproductive and stigmatizing.
As monkeypox hits gay men, officials debate warnings to limit partners
The CDC’s new sexual health guidelines echo WHO Director General Tedros Adhanom Ghebreyesus’ comments, but not quite so harshly. It does not target men who have sex with men. CDC guidelines say the risk of exposure can be reduced by limiting sexual partners, avoiding spaces such as sex clubs where anonymous sexual contact with multiple partners occurs, and wearing clothing, including leather or made of latex, during intercourse as a skin-to-skin barrier.
The guidelines emphasize that behavioral changes may be temporary until a person is fully vaccinated with two doses of monkeypox. Although the United States distributes hundreds of thousands of vaccine doses in the coming weeks, there are not enough to vaccinate all eligible people, and some jurisdictions administer only one of two vaccines for stretch limited stocks.
“These temporary changes will help slow the spread of monkeypox until the vaccine supply is adequate,” the CDC guidelines state.
Prior to the update, the CDC advised only people with confirmed or suspected cases of monkeypox to abstain from sexual activity.
Public health authorities typically focus on ways to reduce the risk of contracting a disease during sex rather than urging people to avoid sex. Some public health officials and experts say people will make their own decisions to abstain from high-risk sexual activity when told about the viruses and their spread.
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Monkeypox has presented messaging challenges for public health officials because it can be transmitted outside of sexual activity, such as by hugging or sharing contaminated bedding, and because condoms don’t offer full protection. against exposure to rashes.
Some public health experts say recommending a temporary reduction in sexual activity is not tantamount to calling for abstinence, which is widely considered ineffective by disease prevention specialists.
“It’s not a forever thing. It’s a thing for now and as we work to scale up biomedical interventions,” said Demetre Daskalakis, a senior Biden administration official spearheading the response. at monkeypox, which has expertise in HIV prevention, during a call with reporters on Friday.
The CDC did not widely promote its new guidelines after posting them online on Friday. An accompanying tweet and video related to the changes did not mention the new recommendations to reduce exposure, including limiting sexual partners. Daskalakis said officials will look to credible organizations in the most affected communities to help promote prevention messages.
Although CDC guidelines do not mention sexual orientation or gender identity, data released by the agency on Friday shows that infections remain overwhelmingly among men who have sex with men.
In 358 male cases with detailed information, 94% report intimate or sexual contact with another male in the three weeks prior to symptom onset.
Nearly 300 men provided additional details about their sexual activity during this three-week period: 40% said two to four partners, 27% said one partner, 19% said 10 or more partners, and 14% said said five to nine partners.
Monkeypox causes flu-like symptoms, including fever, swollen lymph nodes, and a rash that can spread throughout the body. Doctors are seeing more lesions around the genitals, mouth and anus of patients in the latest outbreak, suspected to be linked to sexual transmission.
In 291 cases with detailed symptom data, 42% of patients did not report flu-like symptoms before developing rashes, as is typically seen in patients with monkeypox. In a sample with detailed information on the locations of rashes, just under half reported them around the genitals.
Monkeypox exposes inequality in the gay community as people struggle to access care
CDC data also showed that people of color bear the burden of monkeypox cases at levels disproportionate to their presence in the general population.
In more than 1,000 reported cases of race and ethnicity, 41% were white, 28% Hispanic, and 26% black.
Cases disproportionately affect black people as the outbreak grows, rising from 12% of cases between May 17 and July 2 to nearly a third of cases between July 3 and July 22.