Interview: Infectious outbreaks can lead to discrimination. This is why we should avoid it.

The current monkeypox outbreak may remind us of historically damaging lessons learned from past public health crises, such as when politicians and media outlets falsely blamed the HIV-AIDS epidemic on the LGBTQ community. These scars still hurt the community today

Sometimes, when a new or rare disease starts to spread, the communication around it can become negative, causing stigmatization among certain groups. The onset of the COVID-19 pandemic found people often targeting Asian communities in the US, showing us that as a society, we may not be past blaming some communities for disease outbreaks.

The reports from the US Centers for Disease Control and Prevention 4,106 cases of monkeypox worldwide on June 27. The US has about 200 of those cases, 51 of which are in California.

Although the virus can spread to anyone through close skin-to-skin contact, it is not a sexually transmitted disease.

The World Health Organization and the CDC have some of their posts about gay and bisexual men, after some cases were identified in that community. But that opens up a historically vulnerable group to be stigmatized again.

Sacramento LGBT Center CEO David Heitstuman said the organization is doing outreach but feels parallels to the HIV crisis.

“We’re coordinating and thinking about communicating with other LGBT organizations across the country who see a little bit of what’s happening in their communities,” Heitstuman said. “A lot of people listen back to the beginning of the HIV epidemic when public health wasn’t being paid super close.”

Heitsuman and Alexis Sanchez, director of advocacy and training at the Sacramento LGBT Center, met with Insight Host Vicki Gonzalez to discuss how to talk about monkeypox while reducing the damage.

Remark: WHO is developing a new name for this smallpox virussince that name can be seen as discriminatory and stigmatizing.

This interview has been edited for clarity and length.

Interview Highlights

About how the outbreak is communicated

Heitsumaan: So for us, we’re coordinating and thinking about communicating with other LGBT organizations across the country who kind of see what’s going on in their communities.

And really, a lot of people are listening back to the beginning of the HIV epidemic when public health wasn’t being paid super close. People didn’t think they could get it.

And so right now we’re really focused on giving some general education to community members about what to look out for and what the symptoms are, and how it spreads, and to make sure that if they experience or suspect symptoms that they may have been in contact with someone, that they are contacting their healthcare provider… and are really supportive of what could be going on.

What stands out about how monkey pox is spoken of?

Sanchez: I think it really strikes a balance between raising awareness of the community by not perpetuating negative stereotypes about the community and also communicating accurate information about how monkeypox is transmitted and how it is prevented.

And what I’ve talked about with many of our community members is that the interventions that work to prevent HIV and the spread of COVID go a long way in preventing monkeypox.

There is a higher prevalence of COVID-19, especially in our community at the moment, and there is still a high prevalence of HIV in certain communities in Sacramento.

So when we do things like get tested regularly [for monkeypox]if we do things like use barriers and other forms of protection, that will go a long way in preventing monkeypox.

I think there’s room for nuance, right? In monkey pox, we have to talk about fomite transmission and sweat and other things, but in general we really lean on a general prevention message for all three diseases.

On how labeling a group as a potential vector can cause harm

Sanchez: So something that we saw in the early stages of the HIV/AIDS epidemic was the disease being labeled as a “gay disease,” right?

So we had bisexual men broadcasting. We had cisgender heterosexual couples contracting HIV and not understanding that they could still spread it to other individuals.

So really talk about how [monkeypox] spreads through skin-to-skin contact, through sweat, and saying it can really affect anyone is really, really important.

On if there are concerns about discrimination against LGBTQ+ groups again

Heitsumaan: I want to be hopeful that won’t be the case, and at the same time I think it’s really important that there’s a strong partnership between public health and community organizations that really want to make sure we respond very quickly to these types of outbreaks.

At this point, most cases were [with] people who have been associated with an LBGT focused event in Europe… This is not a disease that discriminates, and so it can infect anyone and most likely will if we don’t get it under control right away.

About how stigmatizing marginalized communities hurts everyone

Sanchez: I don’t think there’s much I can do as an advocate, but it really comes down to everyone really educating themselves and not perpetuating stigma towards certain groups and certain individuals.

When I talk about and advocate for transgender women and transgender women of color… my own background is in public health. I like to talk about the social determinants of health and why marginalized communities are at higher risk for certain diseases.

It’s not because they have certain behaviors, but it’s more about the built environment and less access to primary care, less access to all kinds of resources that will keep a person healthy.

So when I’m talking about prevention, not about perpetuating stigma in communities, I’m also talking about what also puts certain communities at greater risk and what we can do to address some of those things.

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