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As monkeypox spreads, so do concerns about stigma : NPR


A man waits in line for a monkeypox vaccine in Brooklyn, NY, earlier this month.

Kena Betancur / AFP via Getty Images


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Kena Betancur / AFP via Getty Images


A man waits in line for a monkeypox vaccine in Brooklyn, NY, earlier this month.

Kena Betancur / AFP via Getty Images

When the World Health Organization declared smallpox in monkeys a public health emergency over the weekend, it also warned of another threat to society:

“Stigma and discrimination can be as dangerous as any virus” speak WHO Director-General Tedros Adhanom Ghebreyesus.

In fact, the WHO’s emergency committee had previously considered whether such a statement should be made. Can’t reach consensus partly because of concerns about the risk of stigma, marginalization and discrimination against communities hardest hit by the virus.

Global monkeypox epidemic seems to mostly affect men who have sex with other men. A published study inside New England Journal of Medicine found that 98% of people diagnosed with the virus between April and June in more than a dozen countries identified as gay or bisexual men, and WHO says that 99% of cases in the US are related to male-to-male sex.

That means public health systems can target their messages and interventions to specific communities most at risk. But it also carries the risk of stigmatizing those populations, while at the same time sowing complacency in others who may still be vulnerable.

Public health experts stress that monkeypox is relevant to everyone, as it can be spread through skin-to-skin contact and potentially contaminated items such as clothing or towels. And the virus can infect anyone. America has record two cases for example monkeypox in children.

Infectious disease researcher Dr Boghuma Titanji told NPR: “Although we can see clusters mainly in certain groups of people, the virus does not discriminate by race, religion or tendency. sex.

How exactly can leaders educate people about monkeypox without stigmatizing those most likely to get smallpox?

At a Third meetingWhite House adviser Dr Ashish Jha urged people not to “use this moment to propagate homophobic or crosstalk messages”, instead encouraging them to stick to the evidence and facts and do so respectfully.

Steven Thrasher, a writer and professor at Northwestern’s Medill School of Journalism, says part of the solution is to have enough resources to test, vaccinate and support people when they’re diagnosed (the US has been hit by the virus). criticized for limited vaccine supply, but more is expected in the coming weeks). Another part is addressing homophobia.

“Because as long as there’s a homophobic society and people are scared about what it means to move forward, which will make people think they’re gay, they won’t want to move forward.” Thrasher told NPR last month. “And there’s no easy fix for that. It’s a long-term problem that takes long-term thinking to undo and make a difference.”

How to think about risk and be proactive

The monkeypox virus is similar to smallpox and is endemic to Africa – nearly all cases found previously outside the continent have been linked to international travel and imported animals. What’s different now is how it spreads through intimate person-to-person contact, said Jason Cianciotto, vice president. of the Gay Men’s Health Crisis.

“But it doesn’t have to be sexual: cuddling, massaging, sharing beds or towels that come in contact with pustules,” he says. NPR’s Weekend version. “Even if you’re fully clothed, if you’re on the dance floor or dancing near someone, there’s still the potential for disease transmission.”

Dr. Ali Khan, a former official with the Centers for Disease Control and Prevention who has worked with previous outbreaks of monkeypox in Indiana and the Democratic Republic of the Congo, reported that about 95% of infections were sexually transmitted.

He say Morning version the fact that the outbreak was most concentrated in the group of men who have sex with men, provided a good opportunity for prevention activities in this group, which was proactive in capturing information and queuing up to vaccination.

“But it’s a reminder that people who aren’t in this category are at risk and we need to worry – not panic, but worry – and make sure we’re adequately preventing the spread of the disease,” he said. This infection continues to spread.” Khan added that public health data plays an important role in identifying cases, treating individuals, immunizing close contacts and slowing the spread.

Already have 3,487 confirmed case reported in the United States on Monday. And as Cianciotto notes, an increased case count doesn’t just mean more people are at risk – it can mean more vulnerable people are at risk.

“I am really concerned that if the monkeypox outbreak is not brought under control, it will also be concentrated in low-income communities of color where HIV and COVID-19 are concentrated among immigrants. residents, especially the undocumented, who fear access to health care,” he said. “And that would be a tragedy.”

Why stigma is dangerous and how to fight it

Titanji, clinical researcher, says it is so dangerous to public health misinformation that monkeypox is not a concern for anyone other than men who have sex with men.

That’s in part because it causes a stigma, which can prevent infected people from reaching out, seeking care, and alerting those in close contact with them.

“When we’re trying to contain an outbreak, what we want … is for people to seek medical attention when they see suspected lesions, so they can be checked,” she said. and get the treatment they need.

She added that most people won’t need to be hospitalized for treatment, as many tend to recover with supportive care, hydration, and isolation. (CDC says more than 99% of patients can expect to survivealthough some researchers worry monkeypox could mutate and become more dangerous).

The failure to address stigma early on, Titanji added, could also create a sense of complacency among other segments of the population who may not be heeding the public health emergency.

She says it’s important for public health officials to act early and deliver a message that is not only clear, but can earn and restore public trust. For her personally, it involves sticking to the facts, acknowledging the unknown, and being clear that information can change as science evolves.

Cianciotto says there are three main pieces of information he wants to share with men who have sex with men.

“The first is to be aware, but not to panic,” he said. “The second thing is if they have flu-like symptoms or start to have a rash, go see a doctor and stay home, right? And the third is just to take care of each other, right? And that’s the second thing. two is about – understanding and understanding, just like we did with COVID-19. If we don’t feel well, don’t go out, get the help we need and care for and educate each other. together. ”

What the HIV/AIDS response can teach us

Public health experts and advocates are looking back at the HIV/AIDS crisis of the 1980s and 1990s as an example of what not to do.

Titanji explains that because some of the first HIV cases were identified in gay men, it was quickly – and incorrectly – labeled “a gay disease”.

Stigma and blame make many people ashamed, causing pain and grief to the LGBTQ community. It also means that public health officials did not provide the proper resources to tackle the outbreak when it first began.

“Looking back, we know that the impact of that stigma in the early days of the HIV response lingered years later, and we basically played catch-up to steer HIV,” says Titanji. since that time,” said Titanji. added that she sees similarities with today’s monkeypox outbreaks.

Cianciotto, of the Gay Men’s Health Crisis, says one of the most important lessons learned from the HIV/AIDS crisis is the value of a positive approach to sexuality. education. He pointed to New York City, where thousands of monkeypox vaccination appointments were filled within hours, as proof that people from these vulnerable groups would take measures. Take appropriate precautions if correct information is provided.

He added: “We will not end HIV, and certainly will not limit the monkeypox epidemic, by trying to shame people about not having sex or only having sex with others. certain people. “When you arm people with the information they need to make healthy choices for themselves and their communities, and when you help them approach those decisions with self-love and acceptance, , it’s amazing what the community can achieve.”





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