For most of the 60 years that monkeypox has been known to affect people, it has not been known as a sexually transmitted disease. Now that has changed.
The current outbreak is the largest virus-related and has been designated a global emergency. All evidence so far indicates that the disease is spread primarily through networks of men who have sex with men, officials said.
“It’s clearly spread as a sexually transmitted disease (STD) at the moment,” said Dr. Tom Inglesby, director of the Johns Hopkins University Center for Health and Safety.
Public health agencies are turning their attention to those most at risk in an attempt to contain the spread while protecting them, and are attacking the virus based on its current behavior.
On Wednesday, the head of the World Health Organization advised men at risk Monkeypox Consider reducing sexual partners for the time being.
However, this is a complex epidemic that may change in how it spreads and which population groups are most affected. There is also debate over whether monkeypox should be called a sexually transmitted disease, with some critics saying the term creates stigma and could be used to denigrate gay and bisexual men. I am expressing my dissatisfaction.
Monkeypox can also be spread in non-sexual ways, and using condoms and other typical measures to prevent sexually transmitted infections is not enough, Inglesby and other experts said. I’m here.
Here’s what we know.
What makes something STD?
sexually transmitted diseases are generally sexual contactHowever, some STDs are transmitted in other ways. HIV can spread through shared needles. Syphilis can be spread by kissing. A common parasitic sexually transmitted disease called trichomoniasis has been found to be spread through the sharing of moist, wet objects such as sponges and towels.
Monkeypox doesn’t usually spread easily between people, and experts are still trying to understand exactly how it moves from person to person. It has long been common in Africa, where people are infected through bites from rodents and small animals.
However, in May, like many other sexually transmitted diseases, cases began to emerge in Europe, the United States, and elsewhere, showing a distinct pattern of transmission through close contact with an infected person.
The public health worker Who responds to an outbreak plays a big part in how they are structured. Much of the monkeypox research has been done by surgical specialists. sexual health clinic Or specialize in STDs.
Indeed, the U.S. government’s response needs to be guided by people with that expertise, says David C. Harvey, executive director of the National Coalition of STD Directors.
“The sexually transmitted disease field has a wealth of knowledge and expertise in these areas that has been developed over decades to combat the various epidemics and diseases that affect our communities… Today we see monkeypox taking its toll.
Who has monkeypox?
WHO officials said last week that 99% of monkeypox cases outside Africa are in men, and 98% of those involve men who have sex with men. We believe that the monkeypox outbreak was caused by sexual activity at two raves held in Belgium and Spain.
The statistics are the same as reported cases in the United States, according to the Centers for Disease Control and Prevention. As in Europe, cases have also occurred in other groups, including at least 13 people who were female at birth. two children.
The New England Journal of Medicine was published last week. Investigation Hundreds of monkeypox infections in 16 countries. Doctors reported that the suspected means of transmission in 95% of cases was found to be close sexual contact. Researchers noted that it was impossible to confirm sexual transmission.
That idea seemed to be further supported by the finding that most men had lesions in the genital and anal areas, or in the mouth.
Why is there an argument about calling it STD?
While there is broad agreement between health authorities Because Monkey Box is sexually transmitted, some experts debate whether it should be called an STD. They are concerned that the term is unfairly stigmatizing and could undermine efforts to identify infections and curb outbreaks.
When a disease is defined as a sexually transmitted disease that primarily affects men who have sex with men, many may begin to think of it as a “gay disease” that poses no risk to them. said Jason Farley, an epidemiologist at Johns Hospital. Hopkins School of Nursing.
This is what happened early in the AIDS epidemic in the 1980s and contributed to the spread of HIV to other groups. Farley said.
“We have learned nothing from our history,” said Farley, who is gay.
WHO recommendation for men at risk to limit their movements sexual partner It’s wise public health advice, he said. But it also amplifies the “message that this is a gay disease”.
“This is a fine line between the current epidemiologically focused public health approach and the potential for continued emergence of new cases in the general public.
“Monkeypox is not a sexually transmitted disease,” he said. “It’s an infectious disease that can be transmitted through sexual contact.”
What is known about transmissions?
Some researchers have found evidence of the monkeypox virus in semen.a study In Spain, monkeypox virus DNA was detected in semen, saliva and other bodily fluids of an infected man. However, the study does not answer whether the virus actually spread through semen.
Sorting out that could affect our understanding not only of how men spread the infection, but how long they remain contagious. was found in the semen of some men months after they were thought to have fully recovered.
On the other hand, scientists believe that the main route of infection is current outbreak There was skin-to-skin contact during sexual contact with a symptomatic person.
The virus can also be spread through saliva and respiratory droplets during prolonged face-to-face contact, such as kissing and hugging.
Christopher Moores, professor of global health at George Washington University, said researchers are investigating how often and under what circumstances this type of spread occurs.
“To try to exclude anything from the realm of possibilities at this point would be doing us a disservice,” he said.
Officials also say that monkeypox can also be transmitted by touching an infected person’s rash or body fluids, such as towels and bed sheets, that have been previously touched. It is believed to explain the infection in US children.
Why these details matter
Understanding exactly how monkeypox spreads is critical to providing people with the information they need to protect themselves, health officials say.
That said, health officials believe that those currently most at risk are gay or bisexual men who have sex with multiple partners. has shaped much of the work to contain outbreaks, including the prioritization of
the government Shipment of monkeypox vaccine, but supplies are limited. So far, it’s only recommended as post-exposure treatment or for people who have had multiple sex with her partner in the past two weeks in places where monkeypox cases have been reported.
The vaccine is new and authorities are trying to gather data on its exact effectiveness.
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If monkeypox is spread through sexual contact, is it an STD?
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