Why is mpox being spoken about as if it's a gay STD?

Dear Reader,

You’re right that mpox (formerly known as monkeypox) isn’t considered a sexually transmitted infection (STI). In fact, it’s considered a zoonotic disease, meaning that it’s caused by germs that spread between animals and people. During the 2022–2023 global outbreak, mpox spread mainly through skin-to-skin contact. While majority of the cases were reported among men who have sex with men (MSM), the way that the risk of mpox has been communicated to the general public caused some to believe that mpox only affects lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people. Thinking about mpox in this narrow way can have negative consequences for the health and well-being of people within these communities, as well as other communities at large.  

Is mpox a sexually transmitted infection (STI)?

Prior to 2022, outbreaks of mpox were rare and usually linked to infected animals or travel. However, the 2022–2023 global outbreak behaved in different ways. People diagnosed with mpox had far higher rates of skin lesions in the genital and anal region—an area which typically doesn’t have much skin-to-skin contact with anyone except sexual partners. While this may have caused some confusion, mpox is not defined as an STI. This is because it can be spread through both sexual and non-sexual close contact. Additionally, scientists don’t yet know whether the virus can be passed through semen or vaginal fluids.

That said, sex often involves skin-to-skin contact, kissing, and breathing in close quarters—all of which increase the risk of mpox transmission. Mpox can also cause rashes in areas that are hard to see inside the body, such as the mouth, throat, and genital or anal region. These rashes may be overlooked and can cause people to unknowingly spread the virus when they have an active infection.  

Does mpox only affect LGBTQ+ and MSM communities?  

While anyone can get mpox, the 2022–2023 global outbreak disproportionately affected LGBTQ+ communities, particularly men who have sex with men (MSM). Data models suggest that within the MSM community, a small number of individuals with large numbers of sexual partners can explain the spread of mpox cases.  

Why is there a stigma about mpox?

Mpox isn’t an STI, and it doesn’t only affect LGBTQ+ and MSM communities. However, the stigmatization of mpox is part of a larger historical pattern. When new diseases emerge, they’re most likely to impact marginalized groups who already lack access to resources. These same groups may then face blame for the disease’s spread. The HIV & AIDS epidemic in the 1980s is a notable example. Many people falsely believed that only gay men could get infected by HIV, even though it’s a global disease that affects many people across all identities.  

Discussing mpox in this narrow way has negative consequences for the health and well-being of LGBTQ+ people, as well as other communities. Stigmatized groups may face hostility and discrimination. People infected with mpox, regardless of whether they identify as part of these communities, may also be less likely to seek medical help for their symptoms for fear of discrimination. This can then increase their risk of developing severe complications. Additionally, people who don’t identify as part of LGBTQ+ or MSM communities may not follow health and safety precautions if they don’t believe they’re at risk. This can also contribute to disease spread.  

How can you protect yourself and others against mpox?  

There are precautions you can take to reduce your risk of getting mpox and passing it on to others. These include: 

• Minimizing close contact: Stay cautious in areas where minimal clothing is worn, and skin-to-skin contact can occur. Avoid touching objects and materials that a person with mpox has used. You might also wish to limit the number of people you have skin-to-skin contact with. 
• Staying in the loop: Consider exchanging contact details with sexual partners so you can inform each other if you develop symptoms. 
• Consistently using condoms: Using a condom correctly and consistently, though not 100 percent effective, can greatly reduce your risk of exposure. 
• Getting vaccinated: The U.S. Centers for Disease Control and Prevention (CDC) recommends that people who are at risk of mpox get two doses of the JYNNEOS vaccine, four weeks apart. This includes people who have had intimate contact with a person who may have mpox, MSM, and other high-risk groups. 

When new outbreaks of unfamiliar infectious diseases arise, it’s not uncommon for society to place the blame on certain groups of people. In many cases, these harmful claims target marginalized groups, spread stigma, and are rooted in prejudice rather than science. Nuance is critical—it's something that national and local health officials must deal with as they share new information, and they sometimes miss the mark. As an individual, there are several steps you can take to protect yourself and others around you. This includes staying up to date on mpox information in your community and speaking out against the use of stigmatizing language. If enough people like yourself step up and speak out, who knows what change is possible?