The recent global outbreak of largely among has raised concerns homophobia will undermine effective prevention efforts. There are also fears the disease will fuel homophobic stigma and discrimination.
Author
Jennifer Power
Associate Professor and Principal Research Fellow at the Australian Research Centre in Sex, Health and Society, La Trobe University
Even the name monkeypox due to long-held and the false implication the virus is transmitted by monkeys.
The has said the name needs to change, but has not agreed on or announced a new one. Currently, are using the term MPX, the term I will use here.
MPX is, of course, not the first infectious disease to affect men who have sex with men. So there are things we must learn and things we must not repeat from the public health response to HIV.
Lessons from HIV
When HIV emerged among communities of gay and bisexual men in the 1980s, fear and uncertainty about the cause and nature of the virus led to .
HIV was initially named “” or GRID and there was speculation it was caused by men’s excessive sex or drug use (specifically use of ).
As well as sparking calls for a crackdown on the rights and freedoms of LGBTQA+ communities, the view gay and bisexual men were to blame for HIV obstructed effective public health responses.
Famously, in the United States, then President Ronald Reagan until more than 12,000 American citizens had died, and HIV had spread widely into many communities.
Although today, globally, than men, it is still difficult to disentangle or stigma against other affected populations, including injecting drug users or sex workers.
to HIV prevention as people are reluctant to talk about HIV or for fear of being associated with stigmatised groups. It also perpetuates a fundamental lack of empathy for people living with HIV.
For these reasons, it’s important we don’t approach MPX in these terms.
A new approach?
There are of MPX being used to justify homophobic sentiment or actions. However, a crucial difference between this disease and HIV is from HIV.
There is now better understanding of the insidious ways . HIV also taught us to be cautious about the potential for public health messaging to contribute to stigma, especially when an illness is associated with .
Health policy makers have been stigmatising media reporting of MPX. Meanwhile the community-based HIV sector has mobilised existing infrastructure and experience to support for men who have sex with men.
Importantly, we now have better knowledge about the effectiveness of to preventing HIV and other sexually transmissible infections (STIs). affirm the pleasures and benefits of sex, aim to build open dialogue about safe sex and ensure people can seek testing without fear of judgement or backlash.
The impact of sexual moralising
We have learned lessons from HIV. However, MPX has exposed the ways sexual moralising is ever-present in public health, undermining sex-positive health promotion.
Observers of early media responses to MPX note efforts to avoid stigmatising gay and bisexual men have about the ways in which the disease, , can be spread through close physical contact and why gay and bisexual men may be at risk of exposure.
Reporting has been deliberately vague because there is very limited cultural space for speaking about group sex, casual sex or sex with multiple partners without these practices, and people involved, .
Despite increasing acceptance of sexual diversity, people’s outside a married, monogamous relationship is rarely affirmed. Young women, for example, are for having “too many” sexual partners, while calls for comprehensive, are controversial.
While the world has come a long way toward acceptance of same-sex marriage, homophobia often drives condemnation of gay and bisexual men’s sexual cultures.
This is most visible in relation to public health. For example, when pre-exposure prophylaxis (PrEP) first became available to prevent HIV, public funding for it by some on the grounds this amounted to subsidising gay and bisexual men’s .
When considered through the lens of public health, casual sex is . People’s right to seek sex and intimacy can also be devalued or .
We know, however, of sexual identities and sexual connection in people’s lives is the best way to engage communities in sexual health promotion.
A sex-positive approach
As current vaccine supplies for MPX are limited in many jurisdictions, including Australia, to high-risk groups, including men who have sex with men who have multiple sexual partners.
Given men are being asked to disclose their sexual practices to obtain a vaccine, assurance of non-stigmatising health care will be essential for this program to be successful.
A sex-positive approach to MPX prevention will also support more open conversations so people can gain a better handle on risk and prevention, no matter who they are.
Jennifer Power receives research funding from the Australian Research Council and the Australian Department of Health.
