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Reviews | Gay people should change their sexual behavior to fight monkeypox

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Benjamin Ryan has covered infectious diseases and LGBTQ health for two decades and is a contributor to The New York Times, NBC News, The Guardian and the Thomson Reuters Foundation.

In March 1983, writer-activist Larry Kramer published in the New York Native a legendary screed titled “1,112 and counting– a chilling reference to the American case of AIDS which counts two years after the start of the plague.

“If this article doesn’t scare you, we’re in real trouble,” Kramer wrote. He demanded that his gay comrades confront the political establishment who watched them impassively die. But he also blamed gay men who balked at calls to change their own sexual behavior to prevent the spread of AIDS.

Today, in the face of the monkeypox epidemic, gay and bisexual men, including almost all 9,492 US diagnoses happened, stand at a similar crossroads. A virus that is massively transmitted through sexual contact between men is causing great suffering. And although public health officials are now strongly supportive of gay men, they still fail to provide timely prevention and treatment and often fumbling with messages.

As during the AIDS crisis, homosexuals cannot wait for the government. We need to change our sexual behavior now. We must do this as an act of empowerment to protect ourselves.

Until hopefully the monkeypox subsides, that can and should mean reducing our number of partners, skipping sex parties, practicing monogamy, and even being abstinent.

Gay men have an impressive history of providing such local public health solutions. In the early 1980s, gay activists launched a safer sex movement which (often controversially) took on the heady post-Stonewall release of the previous decade. Ultimately, the push helped to significantly reduce sexual risk-taking. HIV transmissions dropped among gay men as a result.

In recent decades, the fatigue of safer sex, as well as the arrival of HIV treatments and the HIV prevention pill, PrEPsent gay men on a come back to higher risk sexual practices. The rise of hookup apps has further fueled a renaissance of sexual liberation among many gay men – who have been reeling since monkey pox suddenly reconnected sex with virus-related terror.

Gay men who have turned to the government for answers on how to deal with this frightening new reality have encountered a public health establishment that has often seemed more apprehensive of their responses to monkeypox prevention messaging. than the virus itself. Many officials hesitated far from clear statements on the best way for the public to protect themselves. Basically, they often failed to communicate emerging scientific theories that if men avoid anal sex – or maybe using a condom during sex – they could at least limit some of the more devastating symptoms of monkeypox, including severe proctitis.

Centers for Disease Control and Prevention officials, including the new White House deputy for monkeypox, Demetre Daskalakis, frequently downplay the central role that sex between men plays in the transmission of monkeypox and exaggerate the rare cases that are transmitted by other means. The agency can’t even bring itself to use the words “gay” or “men” in its monkeypox safe sex materials.

This reluctance is motivated by an ingrained belief that telling homosexuals to change our sexual practices is inherently homophobic or stigmatizing. The notion is partly understandable; he acknowledges that such demands could backfire, given an all-too-human resistance to being told what to do in private matters, especially within a community whose sex life has historically been criminalized. It also recognizes that anti-LGBTQ policies and sentiments (including attacks focused on monkey pox) are on the rise, and that part of the country still uses gay sexual norms to justify discrimination.

However, this thinking also sees gay men as eternal teenagers determined to defy any whiff of paternalism, regardless of the cost to themselves or the community as a whole.

Just as we gay men deserved to know about our disproportionate share of the number of monkeypox cases at the start of this outbreak, we deserve the government’s best advice on how to protect ourselves now. But we cannot sit idly by until public officials realize this too.

It is reassuring to see that many gay Americans are already taking action. Some followed in the footsteps of AIDS activists and published sexual harm reduction guides. Colorful safer sex infographics are circulating on Instagram. And anecdotal evidence suggests that many gay men have indeed already amended their sexual practices to mitigate the risk of contracting this virus.

More encouraging evidence of what is possible comes from Europe. Experts have theorized that changes in sexual behavior could be one of the reasons for the monkeypox curve in Britain flattened. This could soon be our reality if we do the right thing today.

If cantankerous Kramer were alive to see this crisis, he would surely be pounding his fists and demanding that gay people do more. He would only do it because he held his gay brothers in high regard and knew what we were capable of.

As he wrote in the conclusion of his article on New York natives: “Gay men are the strongest, toughest people I know.” Let’s prove him right.