We’re calling out the disproportionate impact of monkeypox (MPV) on LGBTQIA+ communities. It’s up to our society as a whole to curb MPV, and to proactively do our part not to perpetuate homophobia and misinformation that further harms culturally diverse communities.

‍According to the Center for Disease Control and Prevention (CDC), as of September 2022, there have been approximately 52,000 confirmed cases of Monkeypox (MPV) globally and approximately 19,000 confirmed cases in the United States and counting.

The current outbreak has been prone to misinformation and discrimination. The term “monkeypox” is rife with racist and alienating overtones. It has been noted that “monkeypox’s name conjures tales of illness emerging from the jungled heart of darkness to infect the world, but it likely didn’t originate in monkeys.” It didn’t come from Africa, either. MPV was first detected in Denmark and the source may not be monkeys at all—its origins are still speculated.

Violet and Health In Her HUE choose to use the term MPV, and hope others, along with your local pharmacy, primary health care office, and testing sites, are already adopting a less sensationalized term too.

Despite MPV feeling like a new phenomenon in 2022, it was first discovered in 1958 with the first human case of MPV being recorded in 1970. MPV is spread through:

• Touching or close contact, including kissing, hugging, sexual activity, etc., with a person infected with MPV and presenting rashes, scabs, or bodily fluids.
• Touching or using any fabrics or objects used by someone infected with MPV, such as clothing, bedding, and eating or drinking utensils.
• Vertical transmission, which is exposure to a fetus through the placenta.

Devastatingly, recent studies have shown that men who have sex with men (MSM) experience the highest burden of contracting MPV.

A recent study published in the New England Journal of Medicine reported that in a sample of 528 confirmed cases of MPV between April 27 and June 24, 2022, 98% identified as gay or bisexual cisgender men. Regardless of this finding, there is still more research that is needed to understand all risk factors of MPV.

It is important to emphasize that MPV can spread to anyone, regardless of sexual orientation and gender identity. Experts caution that the public should not mislabel MPV as a Sexually Transmitted Infection (STI) only spread within LGBTQIA+ communities.

Since the majority of cases are impacting LGBTQIA+ communities so far, MPV has been labeled as a “gay” disease. This couldn’t be further from the truth.

According to Dr. Carl Streed Jr., "We need to stop seeing transmissible infections, like MPV, as innate to someone's identity but rather a result of behaviors and various social and cultural factors that increase the likelihood of transmission."

Just because MPV hasn’t reached your community yet doesn’t mean it never will. Anyone can get MPV.

Social determinants impact public health. MPV is no different.

MPV is similar to other public health crises, like HIV/AIDS or COVID-19, in that clusters of communities can be grossly impacted because of social determinants of health. Similar to most public health crises, culturally diverse groups, like LGBTQIA+, BIPOC, and low-income communities, are disproportionately impacted.

LGBTQIA+ people of color are particularly vulnerable to the impacts of homophobia, transphobia, and misinformation because they face some of the worst discrimination in health care settings. In a 2020 national survey conducted by CAP Action, 24% of LGBTQ individuals “reported some form of negative or discriminatory treatment from a doctor or health care provider.” Additionally, racial discrimination is the most commonly reported type of discrimination in health care settings. Patients who live at the intersection of LGBTQIA+ and BIPOC identities can be faced with discrimination in reaction to multiple parts of their identities.

There are certain social determinants of health, such as accessible health care or discrimination, that can make some populations more vulnerable to being in poor health. But that doesn’t mean that viruses also discriminate.

“We’ve learned from [the] HIV/AIDS epidemic that it is important to remember viruses can happen to anyone, irrespective of sexual orientation. Everyone should take the proper steps to avoid exposure and reduce transmission. The 'it can’t happen to me' mindset is a breeding ground for worsening any public health concern,” says Dr. Jeaneen A. Chappell, a Health in Her HUE affiliate physician.

Public health crises are exacerbated by social determinants of health, such as intangible factors like political, socioeconomic, and cultural constructs, including racism and discriminiation, and place-based conditions, like accessible health care. Too often, a public health crisis is explained by scapegoating those who are the least privileged in society and could be in poorer health as a consequence. Illness is a factor that alienates vulnerable populations and leads to discrimination, leaving communities unequipped to weather public health concerns and allowing for viruses to spread when so many turn their backs.

As MPV threatens to spread, it is up to clinicians, public health officials, and health care organizations to inform all patients about MPV, regardless of race, gender, or sexual identity. Clinicians must be prepared to uncover biases that may harm their diverse patients in order to properly deliver care to everyone during this crisis and beyond. Since COVID-19 and prior, our society is far too familiar with the harmful impacts of scapegoating a community in the wake of a public health crisis. Acts of racism and homophobia during the HIV/AIDS epidemic are fresh memories for many people, and there’s fear that the current MPV outbreak could become a repeat of history, if it isn’t already.

‍Epidemics worsen health disparities.

In the wake of public health crises, it’s important to address discrimination in order to provide inclusive care, mend trust, and take care of everyone’s health.

Or else the cycle continues where culturally diverse communities are oppressed by a lack of privilege, power, and access and it leads to vulnerability, poor health, and low incomes. These communities become disproportionately harmed when a public health crisis strikes. We are in an endless loop of worsening health disparities because social determinants of health can make communities vulnerable when there are epidemics.

‍Words matter.

‍The spread of misinformation can have a dangerous impact on culturally diverse communities that are already exposed to negative social determinants of health, rooted in homophobia, racism, and discrimination. We must stop spreading hate and misinformation just as urgently as we need to curb the spread of MPV. Stopping the spread of MPV and creating an inclusive, equitable society is everyone’s responsibility—let's start now.