Monkey pox reminds gay men of their early HIV/AIDS days, even if they weren’t around


Eric Sawyer feels a familiar fear. In the gay village of Fire Island Pines, where he owns a bungalow, men have been exchanging rumors of horrific symptoms, checking each other for blemishes, and seeking scant medical interventions. For Sawyer, 68, that kind of anxiety is not an artifact but a scar in his heart.

“While monkeypox is not fatal, just as it is with HIV, there are countless horror stories,” says Sawyer, a veteran activist who in 1987 was on the ground floor of ACT UP, the group committed to ending the AIDS epidemic. . “It opens a lot of raw wounds, and it brings back the intermittent sadness of the death of so many friends.”

Since May 17, nearly 5,200 cases of monkeypox have been identified in the United States, and none have been fatal; The vast majority of infected people worldwide are men who have sex with men, a demographic whose extensive and dense sexual networks are a channel for the spread of a virus that spreads through close and often intimate physical contact.

This scourge may not be as dangerous as HIV, or the coronavirus still causes COVID-19, but monkeypox came at a time when gays in America were already feeling stressed and vulnerable. Sawyer thinks about the last boom of Homophobia, including statewide anti-gay legislation and growing threats and attacks against LGBT people. A social symptom of monkeypox is the fear that the country is heading toward a temporal reversal; In the 1980s, AIDS was first labeled in the media as “gay-associated immunodeficiency”, and the gay community suffered not only from the disease, but from renewed ostracism.

“I fear that an outbreak of a disease like monkeypox in the gay community will exacerbate direct and planned attacks on our society,” says Sawyer.

Despite this, the community has become more visible, stronger, accepting and ready in 40 years, thanks to the work of people like Sawyer, who says he helped discuss vaccinations for 2,000 visitors to Pines over a three-week period in July. From the AIDS crisis, the LGBT community helped design the pandemic response protocols, networks, and models that were used to tackle COVID-19, and now monkeypox.

“There is a straight genetic line, in terms of the culture of what we do,” says Keeletsu Makovani, 35, a social networking epidemiologist who is creating a rapid gay-led study of sexual networking and monkeypox symptoms in New York City to guide the distribution of limited vaccine supplies. ACT UP remains an important mobilization center for people, he says, and LGBT people hold weekly meetings, break up into committees and plan collective action to respond to monkeypox.

“This vocabulary comes from ACT UP and intertwined movements like occupy that resonate,” says McCovani, who works primarily from his ninth-floor apartment in Harlem. “We certainly don’t create structures from scratch.”

Monkeypox is a very different virus from HIV, and 2022 is a light year from 1981. But there is a spiritual echo in the current outbreak, “a cultural reflexive memory that exists even outside of the people who experienced it the first time,” says Demeter Daskalakis, 48 , director of the division of HIV/AIDS prevention at the Centers for Disease Control and Prevention.

There is the government response, which has been slow and scattered, according to public health experts who have criticized the initial lack of clear communication about testing, symptoms and who is most at risk. There is a stigma placed on the society that was first affected. There is intense anger during rallies, at public health agencies, toward anyone who might use an outbreak as a weapon. And skin lesions! Kaposi’s sarcoma was a sign of near certain death in the 1980s, and now monkeypox blisters are a harbinger of acute pain, however temporary and not fatal.

The risks are much lower, in terms of mortality, but the ajita is high. Every heat rash is suspected. Every ingrown hair is sarcasm. Recently gay men were harassed in the street as carriers of diseases. Texting about known exposures — the routine communication between gay men about common sexually transmitted diseases — now has an even more alarming aura. The LGBTQ community screens every health guideline, and every offending tweet, for traces of sexual reprimand or defamation. Modern adjectives and metaphors are exhausted to describe the pain that can accompany infection (“visceral”, “painful”, “knives”, “iron nets”).

“I think we’re all exhausted,” says Nicholas Diamond, 29, director of editorial services at the Elizabeth Glaser Children’s AIDS Foundation (and McCuvani’s husband). “We may have been seeing the light at the end of the covid-19 pandemic tunnel, looking forward to a harsh summer, and now we have to deal with monkeypox and the government really messing up its response without learning the lessons of covid-19. So everyone is tired. And it’s hard to talk about anything when you’re worried If your last trip will make you sick, or your last visit to the pub will make you sick. And I must wonder if that was what our community was thinking in 1981 as well.”

there he is Something scary about sitting in a folding chair in 2022, surrounded by other gay men in folding chairs, waiting to be inoculated by health care workers wearing personal protective equipment and immediately wiping every empty chair with disinfectant. “Moments back,” so was Amanda Carey, The director of the gay men’s sexual health clinic at Whitman Walker in DC, describes it Although at the age of 38, she has not experienced the original moments herself.

On a recent Thursday, Curry told her first patient, whom she was testing for monkeypox, that a testing lab initially prevented phlebotomy specialists from drawing blood from people suspected of having confirmed or confirmed cases. Curry was also wearing full PPE, according to CDC guidelines.

“The patient was like, ‘Wow, he’s just like the ’80s,” Carey says, noting that the patient was also too young to have experienced the height of the crisis. “It’s a disgrace. And it’s also kind of scary, especially at first. With the first couple, she expressed a lot of reassurance: “I’m wearing a crazy costume, but it won’t kill you. You will get over this. It will disappear on its own. We have treatment available. “

An epidemiologist in the metropolitan area in his thirties He contracted monkeypox in mid-June, and suffered five days of fever, night sweats, swollen and groin lymph nodes, and lesions in the genitals and rectum. Deep and deep pain.

“There is cause for stigma and stigma,” says the epidemiologist, who spoke on the condition of anonymity out of concern about stigma. “Oh, if I had HIV, I did it in a very slutty way,” or “If I had monkeypox, I did it in a very slutty way.” Aspects of mental health, disclosure, and stigma are related to each other. How do we get past that? “

One way is to remember a key lesson from the AIDS crisis: educating communities rather than issuing outright bans increases stigma, says CDC’s Daskalakis, who has published guidelines for safe sex and socializing through social networks and influencers.

“Authoritarianism tends to shut down the way people think,” Daskalakis says. “So really thinking about a harm reduction strategy – where you give people the knowledge they need to make informed choices – is how we win.”

Gay men had to be more frank with each other, at the risk of appearing pretentious or alienating. On July 19, AIDS activist Mark S. King wrote an article titled “Monkeypox is a thing like me. We gotta say it.”

Will there be stigma, judgments and homophobia? naturally. “We’re going to have to deal with that,” King wrote. “But that doesn’t mean we bury important facts in vague and elusive messages.”

Sexual positivity certainly defines modern gay life, as does awareness, prevention, and treatment of disease. Nicholas Diamond helped design an information paper last month, titled “Six Ways We Can Have Safer Sex in the Time of Monkeypox.”

Diamond wrote with two of his aides on the rapid monkeypox survey in New York, where the mayor on Monday declared a state of emergency due to the outbreak. “This is temporary and because of the love of group sex and those who enjoy it.”

The World Health Organization followed up last week by essentially saying: Guys, cool down a bit.

“For men who have sex with men, this includes, for now, reducing the number of your sexual partners” and “reconsidering having sex with new partners,” said Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization.

Thrasher, whose new book “The Viral Underclass: The Human Toll as Inequality and Disease Collide” traces the interplay between systemic injustice and vulnerability to disease. “But there is a responsibility that goes hand in hand with the sexual dimension of our lives. It is not just a free orgy for everyone.”

The community is sharing knowledge, lobbying for government action and promoting harm reduction. An eccentric event Friday in San Francisco announced temperature checks, 60 percent capacity, and “approval and health check-in” at the door, where color-coded bracelets were distributed based on attendees’ personal space preferences. On July 25, Washington Blade City Council personally hosted monkeypox At Eaton, on K Street NW, about 50 LGBTQ citizens and public health experts exchanged tips, observations and concerns. Blade’s L.A. counterpart followed July 27 with his town hall, which included a resident named Matt Ford, who was one of the first American men to detail his experience with this outbreak on social media.

Los Angeles commission member Dan Wolfeller said enduring this kind of witness combats stigma and makes the problem real for people. It also goes back to that earlier time.

“In 1983, I saw a young man named Mark Feldman standing in front of a crowd of this size at a synagogue in San Francisco and talking about HIV infection,” said Wollweiler, who has worked in HIV and STI prevention for decades. “. And he said, ‘Anyone who wants to come to the front of the room and see my pests, you can come and do it. “And it was an incredibly powerful moment. And now we have Matt and others come forward and talk about their experience and their symptoms – which fortunately aren’t serious but obviously painful – and I think we really owe Matt and the others a big thank you.”

But all this talk about whether monkeypox should be described as “sex transmitted” or “something like me” — “it’s all just happening because we were surprised, because our government failed to respond proactively,” says Kenyon Farrow, a public health activist at Cleveland area.

As Thrasher wrote in his book, “Individual shame narratives serve not only to shift blame from the state and society to the individual, but also serve to isolate individuals, through politics and society.”

There are larger lessons here, in this current outbreak, as much as the larger lessons that existed during earlier periods – lessons about the persistence of homophobia, structural racism and global injustice that reinforced the inattention to earlier monkeypox outbreaks in Central and West Africa.

“The most obvious conversation we have to have — and it should be clear to everyone from the past two years of contracting the virus — is that our public health system is failing us, right?” says Farrow, managing director of advocacy and regulation at PrEP4All, an organization dedicated to increasing access to HIV drugs. “And we’d better start thinking about how to reimagine public health in the United States, and globally, if we want any chance of not dealing with a continually escalating set of infectious disease crises.”

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