Monkeypox is not considered a traditional sexually transmitted disease as it mainly spreads through close contact with lesions. But global data suggests skin-to-skin contact during sex is fueling the outbreak, leading to more than 7,000 infections in the United States and 26,000 worldwide. Cases reviewed in detail show that infections are prevalent among gay men.
Last week, the World Health Organization leader said men who have sex with men should consider temporarily reducing their number of sexual partners or stopping adding new ones to help stop the outbreak, sparking a debate about whether to call to sexual restraint are counterproductive and stigmatizing.
As monkeypox hits gay men, officials debate warnings to restrict partners
The CDC’s new sexual health guidelines echo the comments of WHO Director General Tedros Adhanom Ghebreyesus, though not quite as bluntly. It does not distinguish men who have sex with men. The CDC guideline says the risk of exposure can be reduced by limiting sexual partners, avoiding areas such as sex clubs where anonymous sexual contact with multiple partners occurs, and wearing clothing, including leather or latex, during sex as skin-to-skin. skin barrier.
The guideline emphasizes that changes in behavior may be temporary until a person is fully vaccinated with two doses against monkey pox. While the United States is distributing hundreds of thousands of vaccine doses in the coming weeks, there aren’t enough to vaccinate everyone who qualify, and some jurisdictions are only administering one of two injections to stretch limited supplies.
“These temporary changes will help slow the spread of monkeypox until vaccine supplies are sufficient,” the CDC guideline says.
Before the update, the CDC had only advised people with confirmed or suspected cases of monkeypox to refrain from sexual activity.
Public health authorities generally emphasize ways to reduce the risk of getting diseases 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 risky sexual activity when given information about viruses and how they spread.
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Monkeypox has presented a message challenge to public health officials because it can be transmitted outside of sexual activity, such as through cuddling or sharing contaminated bedding, and because condoms don’t provide complete protection against exposure to rashes.
Some public health experts say that recommending a temporary reduction in sexual activity does not amount to a call for abstinence, which is widely considered ineffective by disease prevention specialists.
“This is not forever. It’s preliminary and as we work to scale up biomedical interventions,” Demetre Daskalakis, a top Biden administration official who leads the monkeypox response and has expertise in HIV prevention, said during a talk with reporters on Friday.
The CDC has not widely promoted its new guideline after it released it online this Friday. A tweet and accompanying video linking to the changes made no new recommendations for reducing exposure, including limiting sexual partners. Daskalakis said officials will turn to credible organizations in the most affected communities to help promote prevention messages.
While the CDC guideline makes no mention of sexual orientation or gender identity, data released Friday by the agency shows that infections remain overwhelming among men who have sex with men.
In 358 male cases with detailed information, 94 percent reported intimate or sexual contact with another man during the three weeks before symptoms developed.
Nearly 300 men gave additional details about their sexual activity during that three-week period: 40 percent reported two to four partners, 27 percent reported one partner, 19 percent reported 10 or more partners, and 14 percent reported 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 observing more lesions around patients’ genitals, mouth and anus in the latest outbreak, suspected of being related to sexual transmission.
In 291 cases with detailed symptom data, 42 percent of patients reported no flu-like symptoms before developing a rash, as is typically seen in patients with monkeypox. In a sample with detailed information about rash sites, just under half reported them around the genitals.
Monkeypox exposes inequalities in gay community as people struggle to access care
The CDC data also showed that people of color carry the burden of monkey pox cases at levels disproportionate to their presence in the general population.
In more than 1,000 cases where race and ethnicity were reported, 41 percent were white, 28 percent Hispanic, and 26 percent black.
Cases disproportionately affect black people as the outbreak grows, from 12 percent of cases between May 17 and July 2 to nearly a third of cases between July 3 and July 22.