Yet experts say that the insistence on generalizing warnings both hurts outreach to the most vulnerable people, including Black and Latino men, and oversimplifies the lessons of the AIDS crisis, which illuminated the importance of battling stigma and pushing for care for those who needed it.
“We don’t want to add stigma to a delicate situation, but then our messaging becomes so broad that nobody knows which people we’re speaking to — and that becomes a real problem,” Robert Fullilove, a professor of clinical sociomedical sciences at the Columbia University Medical Center, told CNN.
What the early data show
Part of the issue with talking about monkeypox in oblique terms is that we end up overemphasizing who can get the virus and downplaying who does get it, according to Melanie Thompson, an Atlanta-based HIV physician and researcher.
Thompson underscored the importance of clarity, of communication that spells out where, precisely, the virus is.
“The purpose of data isn’t just to crunch numbers — but to ensure that the people most impacted by monkeypox or any other disease entity are getting the services that are required,” she said.
Thompson added, “The message that anybody can get monkeypox spreads fear among the general population. It distracts from the messaging we need to get to people at risk for monkeypox infection.”
And this kind of obfuscation doesn’t merely distract. It marginalizes in a different way, she said.
“The evidence shows that men who have sex with men are at a higher risk than any other population or group,” he said. “So when we talk about directing messages and, more importantly, directing vaccines, we need to make sure that those efforts are purposely targeting the people at highest risk, as opposed to people who might think, ‘Well, why not get vaccinated? It’s just a good idea.'”
It’s worth underlining, experts say, that while Black men appear to bear the majority of monkeypox cases, it’s not because they’re Black.
“When we use race as a way of identifying an important characteristic of a person who’s ill, some people think that race is biologically active — there must be something about brown skin that makes becoming infected with monkeypox more likely,” Fullilove said. “But that’s not the case. What we’re looking at is the dynamic of who hangs out with whom and where they socialize.”
Thompson also injected a note of caution into the conversation.
“There isn’t any sort of racial predilection to monkeypox,” she said. “It has to do with structural racism and the nature of communities and cultural practices.”
She said that Georgia, for instance, is still very segregated along lines of race and sexuality.
“This means that people who are Black are likely to have sexual partners who also are Black,” Thompson explained. “And because they’re a smaller proportion of the population, there’s a higher likelihood of coming into contact with the virus.”
If there’s a silver lining, it’s that it ought to be easier to contain and eradicate monkeypox because we have a more concrete sense of where the bulk of the infection is.
‘AIDS activism wasn’t just about saying the right thing’
Yet that approach strips the period of some of its complexity.
“AIDS activism wasn’t just about saying the right thing,” he explained. “It was about getting care to the people who needed it.”
This isn’t to diminish the value of careful, empathetic messaging.
Thompson thinks that there’s a high level of stigma attached to monkeypox. She said that physicians are hearing from some patients that they’re ashamed to have the virus.
Complicating matters further, she added, is the fact that there are care providers who don’t want to see people with monkeypox — meaning that those with the virus have fewer places to get treatment.
“Our politics often gets boiled down to debates over discourse and messaging that are divorced from the material reality of people’s lives,” Royles said. “Not unlike HIV and AIDS, monkeypox has significant material consequences in your body if you get it. It’s so embodied that it’s deeply ironic that so much of the conversation is focused on discourse, which is disembodied in so many ways.”
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