Scientists: Monkeypox outbreak driven by men having sex with men

Aug 18, 2022

Ryan Robertson Anchor/Investigative Reporter

By Ryan Robertson (Anchor/Investigative Reporter)

We’re three months into the global outbreak of monkeypox. The Centers for Disease Control and the World Health Organization have said the virus primarily spreads through skin-to-skin contact. There’s growing evidence, however, suggesting the virus transmits most easily when an infected man’s semen comes into contact with the mucus membranes of another person. According to the numbers, that other person is usually also a man.

Jeffrey Klausner, an infectious disease doctor from the University of Southern California, and Lao-Tzu Allan-Blitz, a physician in global health from Brigham and Women’s Health Hospital in Boston, recently published an essay reviewing the transmission science of the current outbreak.

They said four major points show sex itself is fueling the outbreak.

First, according to the W.H.O., more than 75% of global monkeypox cases are between men 18-44 years old, which is the typical age breakdown for diagnosing sexually transmitted infections among gay men.

Also, the W.H.O. reported of the more than 38,000 people globally with monkeypox, close to 97% of the cases were diagnosed in men who’ve had sex with other men.

Second, the majority of cases in this outbreak produce lesions in men’s genital and anorectal areas.

Third, researchers found monkeypox in semen and were able to culture the virus, suggesting it could spread through ejaculate.

And fourth, scientists identified an association between specific sexual acts and the location of monkeypox lesions.

One study in the Lancet showed monkeypox transmits most efficiently when lesions come into contact with mucous membranes in the anorectal area, genitals, mouth and throat.

Now, all this is not to say that only men who have sex with men can get or spread monkeypox.

Men, women and children have contracted the virus with no sexual contact–in some cases through simple skin-to-skin contact.

But if the latest findings hold, that the virus spreading through semen is the driving force behind the current outbreak, then experts agreed the messaging about the virus spreading primarily through skin-to-skin contact needs to change.

Klausner and Allan-Blitz recognized the concern that telling the public monkeypox spreads primarily among gay men will fuel homophobia, but they said the cost of keeping quiet puts people at risk by not better understanding how to protect themselves.

Tags: Society at Large

WE’RE THREE MONTHS INTO THE GLOBAL OUTBREAK OF MONKEYPOX. THROUGHOUT, WE’VE BEEN TOLD THE VIRUS PRIMARILY SPREADS THROUGH SKIN-TO-SKIN CONTACT.

BUT THERE’S GROWING EVIDENCE SUGGESTING THE VIRUS TRANSMITS MOST EASILY WHEN AN INFECTED MAN’S SEMEN COMES INTO CONTACT WITH THE MUCUS MEMBRANES OF ANOTHER PERSON. ACCORDING TO THE NUMBERS, THAT OTHER PERSON IS USUALLY ALSO A MAN.

JEFFREY KLAUSNER, AN INFECTIOUS DISEASE DOCTOR FROM THE UNIVERSITY OF SOUTHERN CALIFORNIA AND LAO-TZU ALLAN-BLITZ, A PHYSICIAN IN GLOBAL HEALTH FROM BRIGHAM AND WOMEN’S HEALTH HOSPITAL IN BOSTON RECENTLY PUBLISHED AN ESSAY REVIEWING THE TRANSMISSION SCIENCE OF THE CURRENT OUTBREAK.

THEY SAID FOUR MAJOR POINTS SHOW SEX ITSELF IS FUELING THE OUTBREAK.

FIRST, ACCORDING TO THE WORLD HEALTH ORGANIZATION, MORE THAN 75% OF GLOBAL MONKEYPOX CASES ARE BETWEEN MEN 18-44 YEARS OLD, WHICH IS THE TYPICAL AGE BREAKDOWN FOR DIAGNOSING SEXUALLY TRANSMITTED INFECTIONS AMONG GAY MEN.

ACCORDING TO THE W.H.O., OF THE MORE THAN 38,000 PEOPLE GLOBALLY WITH MONKEYPOX, CLOSE TO 97% OF THE CASES WERE DIAGNOSED IN MEN WHO’VE HAD SEX WITH OTHER MEN.

SECOND, THE MAJORITY OF CASES IN THIS OUTBREAK PRODUCE LESIONS IN MEN’S GENITAL AND ANORECTAL AREAS.

THIRD, RESEARCHERS FOUND MONKEYPOX IN SEMEN AND WERE ABLE TO CULTURE THE VIRUS—SUGGESTING IT COULD SPREAD THROUGH EJACULATE.

AND FOURTH, SCIENTISTS IDENTIFIED AN ASSOCIATION BETWEEN SPECIFIC SEXUAL ACTS AND THE LOCATION OF MONKEYPOX LESIONS.

ONE STUDY IN THE LANCET SHOWS MONKEYPOX TRANSMITS MOST EFFICIENTLY WHEN LESIONS COME INTO CONTACT WITH MUCUS MEMBRANES IN THE ANORECTAL AREA, GENITALS, MOUTH AND THROAT.

NOW, ALL THIS ISN’T TO SAY THAT ONLY MEN WHO HAVE SEX WITH MEN CAN GET OR SPREAD MONKEYPOX.

MEN, WOMEN & CHILDREN HAVE CONTRACTED THE VIRUS WITH NO SEXUAL CONTACT, IN SOME CASES THROUGH SIMPLE SKIN-TO-SKIN CONTACT.

BUT IF THE LATEST FINDINGS HOLD, THAT THE VIRUS SPREADING THROUGH SEMEN IS THE DRIVING FORCE BEHIND THE CURRENT OUTBREAK, THEN THE MESSAGING ABOUT THE VIRUS SPREADING PRIMARILY THROUGH SKIN-TO-SKIN CONTACT NEEDS TO CHANGE, THE EXPERTS SAY.

KLAUSNER AND ALLAN-BLITZ, THE DOCTORS BEHIND THE ESSAY, SAY YES, THERE’S A CONCERN THAT TELLING THE PUBLIC MONKEYPOX SPREADS PRIMARILY AMONG GAY MEN WILL FUEL HOMOPHOBIA, BUT THEY SAY THE COST OF KEEPING QUIET PUTS PEOPLE AT RISK BY NOT BETTER UNDERSTANDING HOW TO PROTECT THEMSELVES.