The notion that mpox (formerly monkeypox) is solely a disease for gay men is a dangerous misconception that undermines global public health efforts and perpetuates harmful stigma. While the recent outbreak has disproportionately affected certain communities, it's crucial to understand that anyone can contract mpox through close physical contact, regardless of their sexual orientation, gender identity, or any other demographic. Facts, not fear, must guide our understanding and response.

Mpox: Debunking Myths, Understanding Transmission, and Prioritizing Protection

In recent years, the world witnessed an unprecedented global surge in mpox cases, prompting the World Health Organization (WHO) to declare it a public health emergency of international concern. This declaration highlighted the urgency of coordinating a global response to a virus that, while historically endemic to certain African regions, demonstrated an alarming capacity for widespread transmission across new populations.

With thousands of cases reported worldwide, the spotlight inevitably fell on understanding how this virus spreads, who is most at risk, and critically, how we can effectively contain it without resorting to stigmatizing narratives. Despite clear scientific evidence, a persistent and damaging myth has circulated: that mpox exclusively affects gay men. Why does this misconception persist, and what are the true facts we need to grasp?

What Exactly Is Mpox (Monkeypox)?

Mpox is a viral zoonotic disease caused by the mpox virus, belonging to the Orthopoxvirus genus - the same family as the variola virus, which causes smallpox. While typically milder than smallpox, mpox presents with a range of symptoms that can be debilitating and, in some cases, severe.

Common symptoms typically include:

Fever: Often one of the first indicators.
Headache: A general feeling of unwellness.
Muscle Aches and Body Pains: Similar to flu-like symptoms.
Chills and Exhaustion: Significant fatigue.
Swollen Lymph Nodes: A distinguishing feature compared to smallpox.
Rash: This is the most characteristic symptom, evolving through different stages (macules, papules, vesicles, pustules, scabs) and appearing on various parts of the body, including the face, genitals, chest, back, and extremities.
Painful Sores: Some individuals may develop very painful sores in the mouth, on the genitals, or inside the anus.

For most people, symptoms resolve naturally within two to four weeks without specific treatment, though some cases can be more severe, especially in immunocompromised individuals or young children.

How Does the Mpox Virus Spread?

Understanding the modes of transmission is paramount to prevention and debunking myths. Mpox is not classified as a sexually transmitted infection (STI) in the traditional sense, but it can absolutely be transmitted during sexual and intimate contact due to the nature of its spread.

The primary method of mpox transmission is through close, prolonged physical contact with an infected individual. This includes:

Direct Skin-to-Skin Contact: Especially contact with infectious rashes, scabs, or body fluids from lesions. This is the most common route in the current outbreak.
Respiratory Droplets: While less common for widespread transmission, large respiratory droplets (from coughing or sneezing) can transmit the virus during prolonged face-to-face contact.
Contaminated Objects: Contact with contaminated materials like bedding, towels, clothing, or other surfaces previously touched by an infected person's rash or bodily fluids. The virus can persist on surfaces for several days, sometimes even weeks, making household transmission possible.

This means that mpox can spread in households or shared living environments through non-sexual close personal contact with an infected person - consider cuddling, hugging, or even sharing bedding. It's a contact-based disease, not exclusively a sexually-transmitted one.

Addressing the Disproportionate Impact on Men Who Have Sex With Men (MSM)

While anyone can get mpox, the current global outbreak has indeed disproportionately affected sexually active gay, bisexual, and other men who have sex with men (MSM). This observation, however, has been tragically misconstrued by some to falsely label mpox as a "gay disease." This is not only inaccurate but also dangerous, as it can lead to stigma, discourage testing, and prevent effective public health outreach.

So, why the disproportionate impact? It's not because gay or bisexual men are inherently more susceptible to the virus. Rather, it's explained by what public health experts refer to as a "network effect." Once a disease is introduced into a specific community or social network where individuals frequently engage in close physical contact with multiple partners (whether sexual or non-sexual), it can spread more rapidly within that network. The initial introduction of the virus into these specific social circles, combined with prevalent close-contact activities within them, led to rapid amplification.

It's crucial to understand: this pattern reflects the circumstances of the outbreak's spread, not a biological predisposition. Equating mpox with a specific sexual identity is a harmful stereotype that has historically hindered public health responses to other diseases, such as HIV/AIDS, by fostering discrimination and diverting attention from universal prevention strategies.

We've already seen reports of mpox infections in women, heterosexual individuals, transgender, and non-binary people, as well as children. The virus does not discriminate based on identity; it simply follows pathways of close contact.

Prevention and Protection: The Role of Vaccination & Public Health

The good news is that we have effective tools to combat mpox. Vaccination is a cornerstone of the prevention strategy, particularly for at-risk groups.

Vaccination Efforts

Many countries, including the U.S. and those in Europe, have expanded access to mpox vaccines like Jynneos (which is FDA-approved for both mpox and smallpox) for individuals at higher risk of exposure. Eligibility criteria typically include:

Sexually active gay, bisexual, and other men who have sex with men who have had multiple or anonymous partners in the last 14 days.
Individuals with known exposure to the virus (post-exposure prophylaxis), where the vaccine can significantly reduce symptoms if given within 4-14 days of exposure.
People who participate in activities or venues where anonymous or multiple sexual partners are common (e.g., group sex, "sex on premises" venues).
Healthcare workers who are at high risk of occupational exposure.

Access to these vaccines is critical. Swift distribution and uptake, particularly within communities where the virus is actively circulating, can significantly alter the course of the outbreak.

Targeted Public Health Messaging

Public health agencies globally (WHO, CDC, ECDC, UKHSA) have made efforts to provide clear, non-stigmatizing guidance. However, the effectiveness of these messages hinges on their reach. Distributing information in places where at-risk groups are most likely to encounter it - such as on dating apps, at community events, and through trusted community leaders - is paramount.

In addition to vaccination, the WHO has recommended that at-risk groups consider measures to protect themselves, such as temporarily limiting the number of sexual partners and taking precautions to avoid skin-to-skin contact with individuals who have symptoms. This type of messaging aims to empower individuals with knowledge without fueling fear or discrimination.

The emphasis must always be on providing accurate, non-judgmental information that fosters trust and encourages individuals to seek testing and vaccination without fear of shame or ostracization.

A Global Response for Global Health

The declaration of mpox as a global health emergency underscores the need for a coordinated international effort. Ensuring equitable access to vaccines, treatments, and diagnostic tools for all countries - regardless of their economic status - is not just an ethical imperative, but a practical one. A virus knows no borders, and outbreaks in one region can quickly become global challenges.

The WHO's coordinated response aims to accelerate research, facilitate the mass production of available vaccines, and distribute resources where they are most needed. The question remains: can the global community respond fast enough to protect vulnerable populations and prevent future waves?

Conclusion: Moving Forward with Facts and Empathy

Mpox is a public health challenge that demands a factual, science-driven, and compassionate response. The dangerous myth that it only affects gay men not only misinforms the public but actively harms efforts to contain the virus by fostering stigma and overlooking transmission risks to everyone else.

To move forward effectively, we must:

Embrace Accurate Information: Understand that mpox spreads through close physical contact and can affect anyone.
Support Targeted Prevention: Advocate for equitable vaccine access and tailored public health messaging for communities at highest risk, delivered in a respectful and empowering manner.
Combat Stigma: Challenge misinformation and discriminatory narratives. Stigma is a barrier to testing, treatment, and ultimately, effective outbreak control.
Stay Vigilant: Be aware of symptoms and seek medical advice if you suspect infection.

By focusing on facts, fostering empathy, and supporting comprehensive public health strategies, we can collectively work towards controlling mpox and protecting the health of all communities.