Amid the current global outbreak of smallpox, several men who have sex with other men have been infected.
However, smallpox is not a sexually transmitted infection, so why is this information part of public health messages and comments?
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UN officials last week expressed concern over unnecessary stereotypes, highlighting a history of problematic stigma.
“Experience shows that stigmatization of rhetoric can quickly disable evidence-based response, fueling fear cycles, alienating people from health services, impeding efforts to identify cases, and encouraging ineffective punitive measures.” United Nations Convention on HIV / AIDS (UNAIDS). ), said Deputy Executive Director Matthew Kavanagh.
The body said the infection comes from close physical contact and “this risk is not limited in any way to men who have sex with men.”
Smallpox is transmitted through close, skin-to-skin contact between anyone, so anyone can get the viral infection, but some local health authorities have made specific mention of sexual orientation.
“A large proportion of cases detected in Europe and North America are among gays, bisexuals or men who have sex with men,” NSW Health said in its newsletter on the monkeypox website, which was updated on Thursday.
“NSW Health urges people who have recently returned from abroad to attend large parties or sex on the premises to monitor symptoms.”
SA Health also notes that “several countries have reported cases in men who have sex with men” and a press release from WA Health this week said: “Many of the recently recorded cases have occurred in men who have sex with men. “.
International outreach events have been dubbed gay festivals, such as Gay Pride Maspalomas in Spain and Darklands in Belgium. However, so far only two cases have been identified in Australia.
But the federal government’s Department of Health does not mention men who have sex with men in advice on monkeypox on its website and a spokesman told 7NEWS.com.au that “they have not used this language … deliberately “.
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NSW Health confirmed to 7NEWS.com.au that the use of sexual orientation in their information was to recognize the international situation and was based on the language used by top Australian organizations that opposed stigmatizing people, including ACON.
While recommending additional surveillance to communities where the infection is known to be circulating is an effort to protect them, some have questioned whether highlighting this specific group is doing more harm than good.
The sexual orientation patterns within the monkeypox case numbers “reflect their social media,” Andrew Lee, a public health professor at the University of Sheffield in the United Kingdom, wrote for The Conversation.
“It could just as easily have been an outburst in a heterosexual friendship network or a group of athletes.
“Would football players have been classified as particularly vulnerable in smallpox comments if the outbreak had spread to a sports match? Would it have involved so much stigma risk then?” Lee wrote.
Lessons from the past
Australian National Association of People Living with HIV and Director of the Australian Federation of AIDS Organizations Scott Harlum says lessons can be learned from the response to the HIV crisis / AIDS.
“We need to be really focused on what the tests tell us,” he told 7NEWS.com.au.
“I’m not saying we don’t address messages to particular communities that the evidence tells us are at particular risk, but we need to relate it not to a group of people.
“It’s not about being gay or having gay sex, the evidence tells us that with the smallpox of the monkey so far it’s about skin-to-skin contact.
“Australia has a very mature and professional public health sector and that is partly due to the legacy of HIV. No one who works in the health sector of the population will be reckless with information and advice.
Harlum says the Australian response to HIV is a “best global standard” and, more broadly, that “we should always be aware when we try to do good with public health, that we do no harm.”
A higher number of monkeypox detection within this community could also be due to the “active health-seeking behavior of gays, bisexuals, or men who have sex with men around sexual health,” he said. NSW ACON Sexual Health Organization
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Sexual health surveillance has been maintained in these communities perhaps more than in other cohorts, as they continue to struggle with what Harlum said are “40 years of stigma” following the troubled HIV campaign in Australia over the years. eighty.
The dangers of stigma in health
“Stigma generally prevents people from revealing, seeking evidence, seeking treatment, seeking attention,” Harlum told 7NEWS.com.au.
“Anything that presents a stigma fog is against this public health effort.”
This can also be exacerbated by ethnic minority groups and some religions and cultures opposed to homosexuality.
Stigma may also make doctors less likely to test patients who do not meet reduced criteria.
“A large number of new HIV notifications in Australia these days are among women,” Harlum said.
“Women don’t usually get tested for HIV when they go to see their doctor because doctors don’t see them as at risk.”
Smallpox is not considered new or dangerous, and the smallpox vaccine is understood to be effective in preventing viral infection.
WHO Global Director of Infectious Risk Preparedness Sylvie Briand said that although the outbreak was “not normal”, she stressed that it was “containable”.
The outbreak and its commentary provide an opportunity to reflect on the need to be aware of the stigma in health messages, but viral infection alone is not believed to pose a serious long-term danger to the Australian public.
“We don’t make a mountain with a mole,” Briand told the World Health Assembly in Geneva.