A “health literate” and socially engaged LGBTQ+ community has been a key factor in keeping Australia’s monkeypox outbreak under control, according to a leading health expert.
Matthew Vaughan, Director of HIV and Sexual Health for the Sydney based sexual health clinic ACON, is working closely with the LGBTQ+ community to encourage an informed response against the virus and is confident “people in our community have always done really well looking out for themselves and others”.
It’s been 100 days since the first case was detected in a Melbourne man, but we have yet to see runaway outbreaks that are evident in countries like the USA, Spain and Brazil.
Across the country, at-risk Australians are lining up to access newly-arrived vaccines to protect themselves against monkeypox. With the Department of Health reporting 102 cases nationally, and the CDC reporting over 45,000 cases globally, the disease continues to spread primarily among men who have sex with men.
Repurposed smallpox vaccines, utilised for the similarities between the two viruses, are being distributed to high-risk individuals across Australia to tackle the growing outbreak, with the Australian government having ordered 450,000 doses of the Bavarian-Nordic vaccine.
With just a few thousand doses arriving each week, efforts have had to be made to prioritise access.
Finn, a 26-year-old lawyer from Sydney’s Inner West, received their first dose just days after vaccines became available.
After speaking with their doctor, Finn was referred to an online form which asked them questions about their sexual history, travel plans, and HIV status, before it was determined that they were eligible for a dose. Finn received the vaccine based on the number of sexual partners they had engaged with in recent months, and their plans to travel through Europe, where many cases of monkeypox are present.
Finn, who identifies as gender nonconforming, took the vaccine in preparation for stops in Germany and France, two countries with high caseloads.
Commenting on the large, potentially scarring lesions that are characteristic of the infection, they’re relaxed.
“I have a pretty sensible approach to [monkeypox], it doesn’t seem to be the most severe illness… but I wouldn’t like to look like that on holiday,” Finn said.
“I have sex with strangers pretty regularly, I would have sex with strangers more if I had more free time, and when I travel, I have more free time, it’s an exciting and fun part of travelling for me.”
Monkeypox has spread among people, primarily in Africa, since the early 1970s, however the 2022 outbreak is the first example of a global spread of the virus, with 91 countries out of 98 experiencing the disease for the first time. For members of the LGBTQ+ community, this rapid onset has caused some uneasiness.
I did feel rushed… I feel a bit uncomfortable about [the vaccine], I don’t really understand the science.
News of the monkeypox virus and its corresponding vaccine came in quick succession, in clear contrast to the many months of anticipation that preceded the COVID-19 vaccine.
“It’s a blind faith and there are questions as to what the f— is happening to your body when this is injected into you,” added Finn.
“I did feel rushed… I feel a bit uncomfortable about [the vaccine], I don’t really understand the science.”
However, it has been broadly reported the LGBTQ+ community tends to have the highest uptake of the COVID-19 vaccine, over other communities, suggesting that issues of vaccine hesitancy will not be as present with this outbreak.
Vaughan, whose organisation is focused on encouraging vaccine uptake, noted “our communities don’t experience as much hesitancy as others, we are a very health literate community”.
Decades of sexual health practices and promotion since the beginning of the HIV/AIDS pandemic, have created a culture of preparedness to deal with community health crises.
The New England Journal of Medicine recently reported in an American study of monkeypox cases, 41 per cent of infections were in those living with HIV, however Vaughan was quick to note that these diseases are not the same.
“It’s a very different situation to HIV, there’s a vaccine, testing is available, and people are coming forward already,” he said.
But he added everything indicated a preparedness to access the vaccine.
“We’ve seen a really good level of engagement… over 10,000 people have signed up for vaccination interest,” he said. “People are genuinely wanting to know what they can do to protect themselves and their partners.
“The vast majority of cases we have seen have been transmitted through extremely close or sexual contact… it’s important that we work together as a community to prevent and reduce transmission.”
While vaccines are a useful form of protection, Vaughan also stressed the value of self-awareness, including checking oneself for symptoms such as rashes, sores, swollen lymph nodes and lesions, as well as considering closing sexual networks and forming “bubbles” of sexual partners.
Furthermore, he stressed the value of sharing contact information from sexual partners, and checking in through QR codes to sex on premises venues, to assist contact tracers, should you or a partner become infected.
Human monkeypox was given its name before current best practices in naming diseases.
Monkeypox is not a sexually transmitted disease and anyone, regardless of sexuality or sexual patterns, is able to become infected. However, prolonged skin-to-skin contact with a person with monkeypox creates opportunities for the virus to spread, and as such, sexual contact is increasingly becoming the hallmark of transmission in this outbreak.
At an address on July 27, WHO Director-General Tedros Ghebreyesus noted that “although 98 per cent of cases so far are among men who have sex with men, anyone exposed can get monkeypox, which is why WHO recommends that countries take action to reduce the risk of transmission to other vulnerable groups, including children, pregnant women, and those who are immunosuppressed.”
There have also been calls to change the name of the disease, with Fadela Chaib, a spokesperson for the World Health Organisation saying: “Human monkeypox was given its name before current best practices in naming diseases.”
The name has been accused of stigmatising both monkeys, and the continent of Africa which most associate with the animals. There have been reports of humans attacking and poisoning monkeys in Brazil, for fear of the animals carrying the disease.
The issue of naming also has the potential to effect those closer to home, with Vaughan suggesting that “the naming of a virus effects people and can push stigma and discrimination, it’s absolutely going to effect multicultural Australians”.
With all factors present, vaccination and community awareness are at the core of managing this virus. Speaking after receiving their vaccine, Finn was confident that they had made the right decision.
“Those sexual health clinics are run by powerful witches, competent staff, good communication, everyone is there to make you feel at ease,” they added.
If you are concerned you may have monkeypox or are interested in accessing a vaccine, speaking to your GP or local sexual health clinic is a good place to start. Up to date information can be accessed through ACON and NSW Health. You can also access a previous article from Central News about monkeypox.
ACON offers counselling services for LGBTQ+ individuals. You can access these services by calling 9206-2000 (11am-1pm). Similar services are also available through QLife at 1800-184-527 (3pm-12am).
*Names have been changed at the request of those interviewed
Main image by Nick Newling.
