Monkeypox: What We Know

On Saturday, the World Health Organization declared monkeypox a public health emergency. This means that they are putting the global health community on high alert that if we don’t act fast we could be heading toward a global pandemic. Yes, a second one.

This is especially urgent for the LGBTQIA+ community since the majority of cases in this outbreak have been transmitted during sex between queer men. Because it has been framed as an STI (while it’s not technically an STI, it spreads easily during sex) and a disease largely affecting the queer population, it hasn’t been treated as the public health threat it truly is. Between homophobia and our sex-negative culture, there is a lot of stigma surrounding monkeypox. We know all too well how devastating that can be for our community from the AIDS epidemic.

There is even anecdotal evidence of people being denied testing. Although monkeypox has been around in humans since the 70s, it hasn’t had much international attention until now, due to the fact that it was only endemic in several West and Central African countries. (We could get into why it was ignored for forty years, but that’s a whole other can of worms).

Keep reading for more of what we know so far.

Why is it overwhelmingly affecting men who have sex with men?

Scientists aren’t sure; this disproportionate spread has not been seen before. One reason may be that queer men have denser sexual networks than straight people. It’s also worth noting that people with HIV also seem to be at significantly higher risk, with 41% of people in the New England Journal of Medicine study being HIV-positive.

What are the symptoms?

In this current outbreak, symptom progression has been atypical. In the past, people have had flu-like symptoms followed by the development of a painful rash. Some people develop a rash before flu-like symptoms (swollen lymph nodes, fatigue, fever, headache) and others never develop flu-like symptoms at all. Many patients have developed localized lesions on their genitals and anal region. Some rashes have been less severe, so keep an eye out even if you don’t have painful lesions.

How is it spread?

It’s spread through “close physical contact,” which seems vague because it is. It has mostly been spread through skin-to-skin contact during sex, although there are a few cases of the virus spreading through contact with linens of an infected person. It can also be transmitted through respiratory droplets, but not nearly as easily as covid. While there is some evidence that monkeypox can spread through semen, it is still unclear. It has also been detected in saliva samples. Another question on the table is whether monkeypox can be spread through asymptomatic transmission.

What’s the treatment like?

The treatment may include anti-viral medication and pain management. If you have a rash, the WHO recommends you keep it clean and uncovered and avoid scratching. They also say to “clean rash with sterilized water/antiseptic; rinse lesions in your mouth with salt water and take warm baths with baking soda/Epsom salts. If your symptoms get worse, contact your health worker immediately for advice.”

How can I protect myself?

Avoid sexual contact with people who have tested positive for monkeypox or who have a monkeypox-like rash. Make sure to wear condoms during sex, especially if you have multiple partners. The US has started distributing a vaccine called Jynneos, although they are currently in short supply and generally restricted to queer men and transgender people with multiple sexual partners. The vaccine is also recommended for people who may have been exposed to the virus, due to the virus's long incubation period.

What if I think I’m infected?

If you think you’ve been exposed, self-isolate and seek medical advice. The WHO recommends monitoring yourself closely for symptoms for 21 days after exposure. Infections are usually relatively mild, but your healthcare provider will be able to tell you if you should seek hospitalization.

The Bottom Line

Keep yourself up-to-date on monkeypox news as this situation develops. And as always, we don’t believe there is any shame in being sexually active or in contracting a virus. Do your best to protect yourself, follow guidance set out by healthcare providers, and if you do contract monkeypox, remember that your health is not an indicator of your worth. Together we can combat this.

P.S., If you enjoy our content and want access to in-depth interviews with experts, personal essays about sex and queerness, Zoom Q&As, workbooks, and to support our mission to bridge the sex ed gap for queer folks, join us on our new Patreon at patreon.com/kikitheapp.