LGBTI Equal Rights Association for Western Balkans and Turkey

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Monkeypox Outbreak in Europe and the risks it poses to gay/bi men and MSM

12 Aug

last updated on 12 August 2022
The recent outbreak of the viral disease Monkeypox (MPX) in the European region is disproportionately affecting gay, bisexual and other men who have sex with men. It is very important to emphasize from the onset that monkeypox is not a disease specific to the LGBTIQ+ community, and that every person who has close contact with someone who is infectious is at risk. Cases have been identified in communities of gay, bisexual and other men who have sex with men who have had recent sexual contact with a new partner or partners; but the risk is not limited to these groups. 
Taking into account that the virus is continuing to spread rapidly in the community, it is important that we as LGBTI+ organizations and networks are at the forefront of the outreach and advocacy work that can help prevent further spread of this virus. 
Below we are sharing some of the most recent updates and information which can be used by individuals, community leaders, health workers and others affected by or working on the monkeypox outbreak. 
Public health advice for gay, bisexual and other men who have sex with men: 
What is monkeypox and what are the main symptoms? 
The monkeypox virus (MPXV) is spread through close contact with someone who has monkeypox or with a contaminated object. Monkeypox spreads more easily during direct skin-to-skin contact – including sex. Crucial are situations in which the virus from affected skin areas of a sick person come into contact with the skin and mucous membrane of another person. This can also be the case when kissing, caressing or cuddling. So far, however, sexual contacts seem to play the main role in transmission, but MPVX can also be transmitted by droplets by the respiratory air during prolonged direct contact or by contaminated objects (e.g. clothing, bedding and sex toys). Condoms do not provide sufficient protection against transmission. Decisive transmission is direct contact with skin lesions (pimples, blisters, scabbed pustules, crusts). 
The main symptoms one should be looking out for are: rashes with blisters on any part of the body (starting on mouth, anus or the genitals if transmitted during sex), inflammation and pain in the rectum, swollen lymph nodes and fever. These symptoms can be accompanied by headaches, muscle aches and low energy. 
How can you protect yourself and prevent infection from MPXV? 
It is important that you learn about monkeypox symptoms and how it spreads. Close sexual contacts and direct skin contacts play the biggest role in transmission so far. Close skin sexual contacts and sexual contacts with unknown persons, whose health status you cannot asses, carries a higher risk of infection. Therefore, it is recommended that you reduce/limit the number of sexual partners and practice safer sex. It is essential to avoid close contact with people who have skin lesions or a rash, or who have flu-like symptoms such as fever and chills. Since it is mainly contact with the affected skin areas that leads to transmission, even condoms do not provide sufficient protection. In addition, it is recommended that you keep your hands clean, using soap and water, or an alcohol-based sanitizer. It is important that if you think you are at higher risk of getting monkeypox, contact your health provider to learn how to lower your risk of infection. 
What to do if you have symptoms and if you have monkeypox? 
If you suspect to have monkeypox seek medical advice by contacting your healthcare provider. Get tested for monkeypox, if advised. Self-isolate as much as you can and avoid close contact with others. Take a break from having sex until you have a negative test result and ask your close contacts and sexual partners if they have similar symptoms. 
In case you have monkeypox then it is important that you self-isolate and follow the advice of health authorities. Avoid contact with pregnant women, young children and immunocompromised people until you have recovered. Take a break from sex until the last scab has fallen off. Share details of close and sexual contacts with health authorities or inform your contacts yourself. Because of current uncertainties about transmission, wear a condom for 12 weeks even after you have fully recovered. 
What if I am planning to attend outdoor events, prides and festivals? 
Attending outdoor events and festivals does not increase the risk of MPXV infection, but close contact, including sex, increases risk of infection. It is important that if you have any monkeypox symptoms – typically a rash – take a break from festivals and crowded events and contact your healthcare provider. 
Is there a vaccine against monkeypox?
Vaccination against smallpox was demonstrated through several observational studies to be about 85% effective in preventing monkeypox. Thus, prior smallpox vaccination may result in milder illness. Evidence of prior vaccination against smallpox can usually be found as a scar on the upper arm. At the present time, the original (first-generation) smallpox vaccines are no longer available to the general public. Some laboratory personnel or health workers may have received a more recent smallpox vaccine to protect them in the event of exposure to orthopoxviruses in the workplace. A still newer vaccine based on a modified attenuated vaccinia virus (Ankara strain) was approved for the prevention of monkeypox in 2019. This is a two-dose vaccine for which availability remains limited. Smallpox and monkeypox vaccines are developed in formulations based on the vaccinia virus due to cross-protection afforded for the immune response to orthopoxviruses. The supply of newer vaccines is limited and access strategies are under discussion. 
Below we are sharing materials for further reading: 

General information on monkeypox 
A video on monkeypox: 100 seconds that could shape your summer
Public health advice on monkeypox for gay, bisexual and other men who have sex with men
Public health advice for gatherings during the current monkeypox outbreak
Interim advice for public health authorities on summer events during the monkeypox outbreak in Europe, 2022.
Risk communication and community engagement approaches during the monkeypox outbreak in Europe, 2022. 
Risk communication toolkit for event organizers 
Vaccines and immunization for monkeypox: interim guidance, 14 June 2022.

Topic - Access to Health / Access to Healthcare
Country - All Countries