The Centers for Disease Control and Prevention released data showing that the monkeypox outbreak was concentrated in men who had sex with multiple men and issued more detailed recommendations for avoiding exposure to the disease.
According to the report, 40% of the 291 men surveyed said they had had two to four partners and 14% five to nine partners in the three weeks before developing monkeypox. About 19% reported 10 or more partners during that period, the CDC said Friday.
And among 86 men who provided information, 28% said they had had group sex, which is defined as having sex with more than two people, at a festival, group sex event or sex party, based on the report. The survey was conducted from May 17th to July 22nd.
After the data was released, the CDC also issued more specific warnings and recommendations for reducing monkeypox risk than its previous guidelines. The CDC also expanded its recommendations to include all sexually active people, not just those who suspect they may be infected.
In addition to recommending limiting the number of sex partners, the CDC recommended wearing latex, polyurethane, or nitrile gloves and changing or cleaning clothing, linens, towels, and sex toys after sex.
The new developments come after cases in the US surged to more than 7,000, prompting the federal government to declare a public health emergency.
Monkeypox is a viral disease spread through close, personal contact that is often skin-to-skin, as well as contact with respiratory secretions, direct contact with a rash or scab, and touching objects owned by someone with the virus, the CDC, can be used on any spread said.
US health officials have declared monkeypox a public health emergency after the World Health Organization declared it a global health emergency in late July. The WSJ explains what to look out for and what scientists know about the spread of the virus. Pictured: Adele Morgan
Direct contact can happen during sex or touching genitals, as well as kissing, hugging, massaging, and touching fabrics and objects used during sex, such as fetish gear, the agency said.
Scientists are still researching whether monkeypox can be spread through semen or vaginal fluid. In a May study of Italian men, monkeypox DNA was present in semen, but health experts said they weren’t sure whether that meant the virus could be transmitted sexually.
Although anyone can get monkeypox, the CDC said in June that the outbreak could be focused on gay and bisexual men because the virus takes advantage of social and sexual networks in this group.
Still, health officials had held back with some direct warnings for fear of stigmatizing the population, according to people familiar with the discussions.
However, the release of the data and guidance points to a new phase in the response, with the Biden administration speaking more directly about who is at risk and how to reduce it.
Government officials expressed hope that the new recommendations could help slow the spread of the virus by reaching those most at risk. The lack of tests, vaccines and medicines has hampered efforts and has drawn criticism from some doctors and health experts.
“Given the current limited supply of vaccines, the CDC recommends making temporary changes to some behaviors that may increase a person’s risk of exposure,” said an agency spokeswoman. “These temporary changes will help slow the spread of monkeypox until vaccine supplies are adequate.”
Even people who feel well should consider taking steps like limiting the number of sex partners, having sex with clothing, and covering areas where a rash is present, according to the CDC. In addition to recommending gloves to reduce exposure, the CDC also detailed the benefits of wearing leather or latex gear.
US health officials are struggling with how to communicate about the virus, which is hitting communities that already face historical discrimination.
Federal officials have been careful to avoid warnings they believe would lead to stigma about certain sexual activities, but that caution has drawn criticism that government leaders are unclear and that news is not getting to the people hardest hit by the virus are threatened.
“They are harming the very group they are trying so hard not to stigmatize,” said Dr. Greg Poland, head of the Mayo Clinic’s Vaccine Research Group.
Without detailed recommendations from the federal government, LGBT activists had written their own safer sex guidelines. A guide discouraged group sex in public places and recommended forming groups of men in small groups who would only have sex with each other.
“I think the CDC should be telling the truth,” said David Kilmnick, president and founder of the New York LGBT Network, who praised the new recommendations. “We have to be direct and real and not sugarcoat anything.”
The head of the World Health Organization warned in late July that men who have sex with men should limit the number of sexual partners they have, think twice about sex with new people and share contact information if they have sex.
The Biden administration originally instituted a strategy known as ring vaccination, which has often worked in cases of household transmission. The approach focuses on vaccination contacts of confirmed patients and people who have had close contacts with these people.
This monkeypox outbreak has instead focused on sexual networks, according to a federal official. Attempts have been made to trace contacts, the person said, but the number of contacts is “significantly larger and often anonymous”.
Because of the challenge, the official said, the administration abandoned the initial ring vaccination strategy, instead encouraging people who may have been exposed or who had multiple partners in areas with high monkeypox transmission to get vaccinated.
The administration tried to do public relations during the last month of Pride. The CDC began talks on June 2 with Interpride, a group that organizes Pride events across the country, to share information about monkeypox with event organizers and attendees. It has also partnered with sites like Grindr to spread monkeypox warnings.
The CDC also worked with social media influencers like Shea Coulee, a drag queen, musician and podcaster, and social media platforms in June to break messages about monkeypox to followers and users.
Monkeypox can cause symptoms such as fever, chills, fatigue, headache, sore throat, and skin rash. Some cases of monkeypox are mild, but others come with excruciating rectal pain or swelling. Symptoms usually appear within three weeks of exposure. The illness usually lasts two to four weeks. CDC recommends the infected isolate for the duration of their illness.
write to Liz Essley Whyte at [email protected] and Stephanie Armor at [email protected]
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