The LGBTQ+ community needs a public health response to monkeypox

MeA 29-year-old gay man living in New York City during the first major wave of monkeypox infections in the United States. We are deeply involved in impacting public health.

So I thought getting a monkeypox shot would be pretty easy. But it took me weeks to do it. It’s even harder for people in my community who have less time and resources. How can I fix this?

Me At the Bedford Park Boulevard subway station in the Bronx, I stepped off Route 4 to a large crowd of masked strangers. Old, young, trans, able-bodied, disabled, we were all about to get vaccinated at the Bronx High School of Science.


To get to that point, I had to identify my own health risks. A few questions — were you having enough promiscuous sex to qualify for vaccination? have you ever had sex with Were you defenseless? With multiple partners? where did you meet in the last two weeks? — I don’t want to answer in front of my closest friends. Of course, who decides what is a “promiscuity”?! This is a judgmental term, not a factual one.

Then I had to look online for reservations and book before they ran out. This was a time consuming task.


In the crowd heading to the Bronx High School of Science, it was surreal to see AIDS survivors in the 1980s next to LGBTQ+ people of my generation. HIV is no longer a death sentence with access to adequate preventative measures (PrEP) and treatment (antiretroviral therapy), but community trauma remains. We came from all over New York City to protect ourselves, our communities, and the public at large.

When I opened the Grindr app (a location-based social networking and online dating application for gay, bi, trans, and queer people), I was shocked to see hundreds of people online in my immediate vicinity. Bronx High School is not your typical Sunday stop for the LGBTQ+ community. It’s not brunch at Manhattan’s West Village. But we got to travel outside our neighborhoods and districts for our common purpose. My friends and I have noticed that people using Grindr have started flagging not only their Covid vaccination status, but their monkeypox vaccination status as well. Grindr is even Encourage users to vaccinate(We know Public Health has dropped the ball when gay hookup apps are facilitating vaccinations in front of local or national public health agencies.)

It’s clear to me, and it should be clear to everyone, that the LGBTQ+ community wants to do their part to stop the monkeypox epidemic. But just as PrEP is a necessary tool to limit the spread of HIV, other public health tools are needed to combat monkeypox.

One of the older men in line, probably in his mid-sixties, was wearing a shirt with the iconic ACT UP slogan, “SILENCE = DEATH.” Self-identification unfairly mandates access to health care services for LGBTQ+ people, but what other group boasts such a level of health awareness?In Covid-19, individuals protect themselves However, expectations have grown for public health to provide additional tools such as remote diagnostic tests, realistic protocols and guidelines, and, ultimately, easily accessible vaccines. Both the World Health Organization and the Centers for Disease Control and Prevention urge men who have sex with men to reduce or stop having sex with new partners and to be vaccinated, but there is little information on how to do so. Not provided.

There are limits to what the LGBTQ+ community can achieve without institutional support. (Hello Federal Government! What have you been doing? Robert Fenton was appointed as the White House’s monkeypox coordinator, but not until three states had already declared a state of emergency. .)

New York City’s first 1,000-dose monkeypox clinic in Manhattan’s Chelsea neighborhood had to close its lines after about 90 minutes. The San Francisco Department of Health confirmed that the monkeypox vaccine at the city’s clinic in early August ran out of him in less than a day. Georgia has emerged as a hotspot for monkeypox, but when vaccination booking links go live due to overwhelming demand, the Department of Health’s website crashes regularly, leaving more citizens than ever before. The vaccine is no longer accessible.

When I went to see a nurse at the Bronx High School of Science, there was some confusion about whether a second dose of the vaccine could be done. It was trying to decide whether the supply of the vaccine should be expanded by vaccinating more people with a single shot, rather than by vaccinating more people.

After I had my first shot, the Biden administration allowed one-fifth of the monkeypox vaccine to be used. While this sounds like a good idea, health care workers have struggled to learn how to administer the vaccine intradermally when needed, resulting in wasted doses on a regular basis. Why was this plan approved before the division could effectively operate it?

The problem is not just vaccine shortages. Monkeypox testing is limited and WHO And while the CDC is advising people to limit their sexual partners, this is not an effective long-term solution.Be aware of the surge in STDs during Covid-19. This includes her 24% increase in the incidence of primary and secondary syphilis among women of reproductive age during a time when people were supposed to social distance. (Also, imagine straight people being chosen to quit sex as a public health measure!)

Tests should also be made more accessible. Health departments across the country should consider enabling home diagnostics for monkeypox to help the entire LGBTQ+ community combat the epidemic. This will enable at-risk members of this community to access care without official self-identification and will help parents, shift workers, individuals with disabilities, and resources seeking care outside the home. The Center for American Progress found that 31% of LGBTQ+ people living outside metropolitan areas have access to multiple community health centers and clinics. reported finding it very difficult or impossible to

Some hospitals, clinics, and public health initiatives are building on the popularity of telemedicine, with its use increasing by more than 150% during the Covid-19 pandemic, with continued telemedicine options and home diagnostics. Improving access to healthcare through testing. Home diagnostics are currently used in STD testing, infertility screening, primary care, medication management, chronic disease care, and more. Why not use this option to increase access to monkeypox testing and remote care? In particular, multiple studies (Kaiser Family Foundation, Rutgers University, etc.) show that telemedicine is an effective way to reach the LGBTQ+ community. What if the FDA-approved monkeypox test can detect monkeypox in lesion samples, just like the test for herpes?

The larger public health community needs to take action to stop monkeypox, just like they did with Covid-19. Provide free vaccines for all, improve telemedicine access, enable Operation Warp Speed ​​to accelerate development of monkeypox vaccines and treatments, and conduct mass information campaigns to reduce the spread of the disease. spread awareness about The LGBTQ+ community has largely had to defend itself as it continues to respond to the AIDS epidemic. The time has come to step up institutional support to contain the virus.

David Stein is CEO and co-founder of Ash Wellness, a New York City-based company that works with partners to enable at-home testing programs.

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