Mpox containment: success of the community?

They were headlines that nobody wanted to read: In May 2022, in the midst of the coronavirus pandemic, the media reported a "monkeypox outbreak" in Europe. The virus soon spread across the continent at a speed that worried experts.

However, the majority of the population soon seemed to breathe a sigh of relief. It is true that "monkeypox" is not a sexually transmitted disease in the strictest sense; the virus can be passed on through close skin contact. However, the vast majority of those infected were, and still are, men who have sex with men. According to the Robert Koch Institute, out of a total of 3,670 cases nationwide (as of 6 December), only 19 female cases, four cases in male adolescents and two cases in children under 14 years of age have been reported to date.

In international reporting, this led to "monkeypox" soon being incorrectly labelled as a "gay disease" by some media outlets. For some, this brought back dark memories of the media's discriminatory and erroneous handling of the AIDS crisis in the 1980s. Back then, HIV and AIDS were also dismissed as something that only affected gay men. 

Stigmatisation of the communities

"Because the group of gay and bisexual men made up the majority of cases, some of the reporting made it sound as if it was a disease that only affects gay men," says Timo. The 27-year-old student lives in Berlin and actually goes by a different name. However, because the topic is still associated with stigma, he prefers to remain anonymous. "The name 'monkey pox' felt very discriminatory," he continued. 

The World Health Organisation (WHO) has also recognised that the name "monkeypox" has a stigmatising effect on those affected. "Following consultations with global experts, the WHO will begin to use the new preferred name Mpox as a synonym for monkeypox." These are the words of a statement from the organisation.

"In clubs, women have said to me that they don't want to drink from my bottle because we gays are dealing with monkeypox"

Timo

But it wasn't just the reporting that Timo found problematic. It was also difficult for him how people outside the community dealt with the outbreak: "In clubs, women said to me that they didn't want to drink from my bottle because we gays have to deal with monkeypox," reports the Berliner-by-choice. 

However, the most inglorious role during the Mpox outbreak was probably played by the state. Its actions or inaction during the peak phase left many perplexed and angry. This is because the vaccination campaign against the virus was delayed in many places - even when the vaccine was already available in some cases. It almost seemed as if nothing had been learnt from the coronavirus pandemic.

Failed vaccination management and its far-reaching consequences

Berlin, of all places, attracted negative attention with its consistently unsuccessful vaccination management. Yet the city was Germany's Mpox hotspot, and nowhere else were as many people infected with the virus as in Berlin. According to the Daily Mirror the metropolis was storing around 8,000 vaccine doses that could not be administered due to bureaucratic obstacles.

Holger Wicht, press spokesman for Deutsche Aidshilfe, told the rbb"Those responsible have to ask themselves whether they really take the protection of those affected, especially men who have sex with men, seriously."

"Those responsible have to ask themselves whether they really take the protection of those affected, especially men who have sex with men, seriously."

Holger Wicht, press spokesman for Deutsche Aidshilfe

The failed vaccination management not only meant that those willing to be vaccinated did not get the vaccine and the risk of infection remained high - but also had much more far-reaching consequences, according to Dirk Sander, also from Deutsche Aidshilfe: "There was also anger and sadness in the communities because people had been looking forward to a relatively corona-free summer. The psyche of some was not the best. I also heard from the scene that the consumption of alcohol and other drugs during this time was 'partly suicidal'."

According to Sander, many gay and bisexual men simply felt left in the lurch: "Statements such as: 'They should keep their feet still, then they won't need a vaccination' have contributed to this feeling," he explains. 

Timo also knows how difficult it was to get a vaccination at the beginning: "I tried to get a vaccination appointment with my GP." But he was told to try again in four to six weeks. The student was also put off calling the specially set up vaccination hotline. He quickly felt disillusioned - and the feeling that he was on his own. 

Containing the virus thanks to the communities

He therefore decided to proactively limit his sexual behaviour. "Friends told me how painful an infection can be. It just worried me too much," he explains. He was also afraid of the three-week isolation. "Having to spend three weeks alone in my flat in the middle of summer - I was just too scared of that." 

Maurice, who actually has a different name, and his partner, with whom the 29-year-old lives in an open relationship, also decided to take action themselves: "We radically renounced any sexual adventures," he reports. And he also had to wait a long time for a vaccination: "I wrote to 25 practices until I got an appointment after about three weeks," says Maurice. 

"It has already been proven that gay and bisexual men adapted their behaviour after the first media reports. Otherwise, the course of the epidemic would be inexplicable."

Dirk Sander, German AIDS Service Organisation

Like Timo and Maurice, many other men who have sex with men have also restricted their sexual behaviour. Sander says: "It has already been proven that gay and bisexual men adapted their behaviour after the first media reports. Otherwise, the course of the epidemic would be inexplicable. The vaccinations came quite late and then bit by bit." According to the RKI, the number of Mpox cases has been declining since August, with only single-digit case numbers reported since mid-October. During the peak phase, there were 420 cases per week.  

A success that the communities, not the state, can take credit for. But does the Mpox outbreak have long-term consequences? Have gay and bisexual men possibly lost the fun and desire to have sex? Sander says: "Based on internal statistics from the leisure sector of gay men, you could clearly see that the mood was changing again: after more and more people were vaccinated and the numbers fell, behaviour returned to normal. Fortunately!"

According to the Standing Committee on Vaccination (STIKO), the vaccine is now available throughout Germany. Anyone who has only received one dose or none at all should now be able to get an appointment quickly and easily. The expert group advises anyone who has only received the vaccine once to get a second dose. Anyone who has not yet been vaccinated should do so, according to the STIKO. "The outbreak is not over yet..."