猴痘病例呈上升趨勢，尤其是在酷兒身上；當感染時這就是可能的情況。

資料來源：Patrick Waechter/ BuzzFeed / 2022 年 6 月 10 日 / aidsmap / 財團法人台灣紅絲帶基金會編譯

猴痘不是一種「同性戀疾病」，但專家們擔心目前男男性行為者中的病例正在上升。 以下是如何避免感染以及感染猴痘的情況，包括症狀和病變圖片。

    

圖片：提供給 BuzzFeed 新聞； Marco 的搭檔手上出現猴痘腫塊

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40 歲的馬可和他的伴侶住在阿爾伯塔省埃德蒙頓。 Marco 的搭檔已經「感覺不舒服」了幾天——低燒，有些疲勞，手上還有一些小疙瘩，他沒有多想，因為它們看起來並不嚴重。

馬可和他開玩笑，暗示可能是猴痘。「我的意思是，機會有多大？像 60 億分之一？」，他告訴 BuzzFeed 新聞。

那時，阿爾伯塔省只有一例猴痘病毒確診病例。

第二天，Marco 的搭檔接到一名公共衛生護士的電話，告知他與一名猴痘檢測呈陽性的人有過密切接觸。 Marco 也和護士說話，告訴她他感覺很好，但他的舌頭下似乎有潰瘍，只是不是特別敏感。

「我剛吃了墨西哥捲餅和瓦倫蒂娜醬，一點也不疼」，他說。（辣醬會導致大多數口腔潰瘍灼傷。）評估他們的風險和症狀後，護士要求他們倆立即進行檢查。

在他們進行檢測兩天後，馬可和他的伙伴又接到了公共衛生護士的電話。「剛接到電話，我們都對猴痘呈陽性反應」，他週三告訴 BuzzFeed 新聞。

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猴痘仍然比較少見，但病例呈上升趨勢

一場新的猴痘疫情正在美國、加拿大和歐洲蔓延，許多最初的病例發生在酷兒身上。根據世界衛生組織的數據，截至6月8日，全球目前約有1,200例猴痘病例，其中英國321例，加拿大100例，美國39例。十五個不同的州出現了病例，包括加利福尼亞、紐約和佛羅里達。

有理由擔心，但這不是另一個 COVID。該病毒不是更具傳染性或更容易傳播，而且已經有兩種猴痘疫苗。一種是 Jynneos（也稱為 Imvamune 或 Imvanex），另一種是 ACAM2000。即使在接觸或感染後，它們也可以幫助預防症狀。

雖然大約 3% 到 6% 的猴痘患者會死於感染，這對兒童和免疫功能低下的人來說更危險，但目前傳播的病毒株似乎更溫和，類似於西非流行的病毒株。另一種更危險的猴痘病毒是中非特有的。

這些案件發生在許多城市正在進行驕傲活動之際。人們在旅行和慶祝的時候，對許多人來說是自 

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2019 年以來的第一個夏天，那時他們終於可以在不受 COVID 限制的情況下聚集在一起。公共交通或許多城市不再強制要求戴口罩。由於密切接觸是病毒傳播的一種方式，衛生專家保持警惕，迅速努力向 LGBTQ+ 社區宣傳性傳播感染。

但要明確一點——猴痘在技術上並不是一種性傳播感染，儘管有些人報告說他們的生殖器有損傷或在性接觸過程中感染了病毒。這種疾病可以透過任何形式的近距離或身體接觸傳播，包括擁抱和親吻、共用毛巾或床單，甚至在長時間面對面接觸時呼吸或說話時產生的呼吸道分泌物——因此，戴口罩可以幫助阻止病毒的傳播。

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猴痘不是一種新疾病。它於 1958 年首次在用於科學研究的猴子身上發現（因此得名），並於 1970 年首次在人類身上觀察到。在它流行的地方，它會在囓齒類等動物中自然傳播，偶爾會跳到處理受感染動物的人類身上或被它們咬傷或抓傷。

儘管 2003 年在美國中西部爆發了疫情，但在非洲以外或最近沒有去過流行地區的人群中，病例並不常見。在這種情況下，有 70 人從與進口的老鼠和睡鼠一起飼養的寵物土撥鼠身上感染了病毒。

一般來說，猴痘的症狀包括發燒、頭痛、肌肉酸痛、背痛、淋巴結腫大、寒戰和疲憊。症狀通常在暴露後 7 到 14 天出現，但它們可以在 5 到 21 天的任何時間出現。症狀開始後大約一到三天，人們通常會出現皮疹和凸起的病變，最終結痂並形成脫落的結痂。總體而言，症狀可持續長達四個星期。

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Marco 發現他和他的伴侶的症狀與他在公共衛生機構網站上看到的不同。

「你知道當人們開始出現症狀時，他們會去找谷歌醫生」，馬可說。 「你會看到徵象和症狀，但沒有人說徵象和症狀會有所不同」。

根據疾病預防控制中心的說法，感染猴痘的人可能會在臉上出現皮疹，然後擴散到身體的其他部位。

Marco 指出，他和他的伴侶都沒有出現皮疹。「皮疹應該會變成全身的膿皰」，馬可說。「這也沒有發生在我們身上，除了可能在我的舌頭下」。

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猴痘不是「同性戀疾病」，可能會被污名化是一個問題

Marco 要求我們只使用他姓名中的名，只是為了避免對他或他的伴侶的診斷造成潛在的污名，但他也想分享他們的經驗以防止病毒進一步傳播。

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恥辱感深植入了 LGBTQ+之體驗中。

自 1980 年代愛滋病毒/愛滋病疫情流行以來，它曾一直與酷兒男性有密切關聯。有些人擔心猴痘會走同樣的路。今年，國際愛滋病毒/愛滋病組織，聯合國愛滋病規劃署，發布了一份聲明，指出在有關猴痘的公共傳播中提及 LGBTQ+ 人群以及非洲人會造成污名化。

除了造成社會危害外，聯合國愛滋病規劃署還警告說，此類關聯可能會給公共衛生帶來更多問題。該計畫的副執行主任馬修·卡瓦納博士(Dr. Matthew Kavanagh)在新聞稿中說，「污名傷害了每個人。共享科學和社會團結對每個人都有幫助」。

其他人則表示，當公共衛生受到威脅時，對污名的擔憂就不那麼重要了。歷史學家吉姆·唐斯（Jim Downs）最近為大西洋雜誌寫了一篇題為「男同性戀者需要關於猴痘的特別警告」的文章。在那篇文章中，Downs寫道，「給男同性戀者精心訂制的猴痘風險警告可能是一種教育形式，而不是一種恥辱」。

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愛滋病毒/愛滋病活動組織 ACT UP 的原始成員之一彼得·斯塔利(Peter Staley)對此表示贊同。他說，酷兒男性總是會遭受污名，無論是透過圍繞猴痘的言論還是其他方式。

「右翼將竭盡全力攻擊我們。他們一直都有，而且永遠都會」，他告訴 BuzzFeed News。「我們永遠不應該讓這種情形去主宰男同性戀者如何去談論健康和風險」。

 

Staley 完全承認，傳播有關猴痘的風險可能會導致更廣泛的公眾將病毒與酷兒聯繫起來，從而造成污名。

「你必須同時打兩場戰鬥。我們需要透過有針對性的信息向男同性戀者宣傳。我們亦需要準備好對抗當為一般公眾傳遞制定的信息時所產生的污名」。”

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就在 5 月 19 日美國報告第一例病例幾週後，關於猴痘的針對性信息已經傳達到該國的酷兒男性。這種靈活敏捷的溝通，可能是透過預防愛滋病毒/愛滋病和其他性傳播感染的現有基礎設施來實現，這些基礎設施是透過運動以觸及 LGBTQ+ 相關人群。

鑑於 6 月是驕傲月，疾病預防控制中心迅速採取行動，派遣其愛滋病毒/愛滋病預防主任 Demetre Daskalakis 博士與健康團體和組織接觸，宣傳猴痘。他和他的團隊計劃在本週與多個驕傲組織者交談。Daskalakis說，今年夏天的聚會可以被認為是機會多於風險。

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「我相信 Pride 是教育人們的絕佳機會。當我思考我們的建議時，它實際上是為了讓人們了解他們所需要的訊見以駕馭整個夏天可能發生的事件，無論他們是否參加 Pride」，他告訴 BuzzFeed News。「我傾向於不認為這是有風險環境的地方，因為實際上它是為了降低自我的風險，去擁有正確的信息來領航你願意做的事情」。

Daskalakis 認為，與 2008 年爆發的抗生素耐藥葡萄球菌感染之 MRSA 相比，猴痘的激增與 80 年代開始的 HIV/AIDS 大流行更相似。所謂的食肉細菌最初在酷兒群體中傳播，然後傳播到普通人群。

「它是如此相似，因為它是透過非常密切的接觸傳播的。當然，性可能是密切接觸或其他親密關係的原因之一」，Daskalakis說道。

回到那時，和現在一樣，機構透過醫療保健提供者發出了類似的警告，特別是那些專注於愛滋病毒/愛滋病的機構，他們有更多的酷兒客戶群。那是在智能手機和基於位置的約會應用軟體出現之前。現在，溝通擴大了。

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這些應用程式中最受歡迎的 Grindr 已經發布了多個關於猴痘的信息警告。該應用程式在美國、加拿大和大多數歐洲國家/地區的每個用戶的收件箱中都發送了一條由當地衛生機構撰寫的消息，以及來自該國更多來源之官方信息的鏈接。

「我們不是公共衛生機構，但我們是優秀的連結組織」，Grindr 的傳播副總裁 Patrick Lenihan 說。 「我們的用戶想要這些信息，而這些團體想要分發這些信息以保證這一人群的安全」。

在美國，Grindr 正在與一個名為「構建健康線上社區」的組織合作，該組織旨在透過連接公共衛生專業人員和約會應用程序式提供有關性健康的有針對性的信息。該應用程式已與加拿大公共衛生署建立聯繫，向其用戶發送警告信息。

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如果您認為自己罹患猴痘該怎麼辦

圖片：提供給 BuzzFeed 新聞 ；一名加拿大公民的舌下可見猴痘腫塊。

 

公共衛生專家建議，如果您或您的伴侶最近有任何疾病、皮疹或病變，請告知所有性伴侶並避免親密接觸。如果您或您的伴侶認為您罹患有猴痘，請待在家裡，盡可能隔離，並致電您的醫生。

回到阿爾伯塔省，Marco 和他的搭檔通常很社交，他們一直在家隔離等待實驗室測試的結果。雖然他們都檢測出猴痘陽性，但他們現在正在等待溫尼伯傳染病實驗室的確認，這還需要幾天時間才能回來。

他繼續向 BuzzFeed News 發送有關他們疾病進展的更新。在這對伴侶進行測試後的第二天，Marco 注意到他的下巴上除了舌下的疼痛外還有兩個新的損傷。又過了一天，他醒來時發燒，還有一個傷口，這次是在他的手上。

他的搭檔感覺好多了。他的燒退了，病灶處還有一點揮之不去的疼痛。

馬可說，他了解猴痘這樣的疾病如何在酷兒人群中迅速傳播，但他希望每個人——無論他們的性別認同為何——都能夠教育自己去尋找什麼以及如何保護自己。

「我們自然更親近，更親熱。我們沒有那種不互相擁抱或親吻的有毒心態」，馬可說。「但僅僅因為它始於同性戀社區，並不意味著它會停止」。

 

 

 

 

 

 

Monkeypox Cases Are On The Rise, Particularly In Queer Men. Here’s What It’s Like To Get The Infection.

Monkeypox is not a “gay disease,” but experts are concerned about currently rising cases among men who have sex with men. Here’s how to avoid infection and what it’s like to have monkeypox, including symptoms and pictures of the lesions.

 

Patrick Waechter/ BuzzFeed Contributor/ Posted on June 10, 2022, 1:22 am

 

 

Provided to BuzzFeed News

Monkeypox bumps seen on Marco’s partner’s hand

Marco, 40, lives with his partner in Edmonton, Alberta. Marco’s partner had been “feeling off” for a couple days — a low fever, some fatigue, and a few little bumps on his hands, which he didn’t give much thought as they didn’t look serious.

Marco joked with him, suggesting that it might be monkeypox. “I mean, what are the chances? Like 1 in 6 billion?” he told BuzzFeed News.

At that point, there was only one confirmed case of the monkeypox virus in all of Alberta.

The next day, Marco’s partner received a call from a public health nurse letting him know that he had been in close contact with a person who had tested positive for monkeypox. Marco spoke with the nurse as well, telling her that he felt fine, but he did have what seemed to be a canker sore under his tongue, only it wasn’t particularly sensitive.

“I just had tacos with Valentina sauce on them, and it didn’t hurt at all,” he said. (The hot sauce would cause most canker sores to burn.) Assessing their risk and symptoms, the nurse asked both of them to come in for testing right away.

Two days after they went in for testing, Marco and his partner received another call from the public health nurse. “Just got the call we are both positive for monkeypox,” he told BuzzFeed News on Wednesday.

Monkeypox is still relatively rare, but cases are on the rise

A new outbreak of monkeypox is spreading throughout the US, Canada, and Europe, and many of the initial cases have been in queer men. According to the World Health Organization, as of June 8, there are now about 1,200 monkeypox cases worldwide, including 321 in the UK, 100 in Canada, and 39 in the US. Fifteen different states have had cases, including California, New York, and Florida.

There is reason to be concerned, but this is not another COVID. The virus is not as contagious or as easy to spread, and there are already two monkeypox vaccines. One is Jynneos (also known by the brand names Imvamune or Imvanex), and the other is ACAM2000. They can help prevent symptoms even after exposure or infection.

While about 3% to 6% of people with monkeypox can die of the infection, which is more dangerous in children and people who are immunocompromised, the strain of the virus currently spreading appears to be milder, similar to the one endemic to West Africa. A more dangerous strain of monkeypox is endemic to Central Africa.

The cases are happening just as Pride events are underway in many cities. People are traveling and celebrating during a time that for many is the first summer since 2019 when they can finally gather free of COVID restrictions. Mask mandates are no longer in place on public transit or in many cities. Because close contact is one way the virus can spread, health experts are on alert, working quickly to get the word out about STIs to LGBTQ+ communities.

But to be clear — monkeypox is not technically an STI, although some people report having lesions on their genitals or acquiring the virus during sexual contact. The disease can be spread through any kind of close or body contact, which includes cuddling and kissing, sharing towels or sheets, or even respiratory secretions from breathing or talking during prolonged face-to-face contact — so, wearing a mask can help stop the spread of the virus.

Monkeypox is not a new disease. It was first discovered in monkeys used for scientific research (hence the name) in 1958 and first observed in humans in 1970. In places where it is endemic, it naturally circulates in animals such as rodents, occasionally jumping to humans who handle infected animals or are bitten or scratched by them.

Cases are uncommon outside of Africa or among people who have not recently traveled to an endemic area, though there was an outbreak in the Midwestern US in 2003. In that case, 70 people got the virus from pet prairie dogs that were housed with imported rats and dormice.

In general, monkeypox symptoms include fever, headaches, muscle aches, backaches, swollen lymph nodes, chills, and exhaustion. The symptoms usually show up 7 to 14 days after exposure, but they can appear anywhere from 5 to 21 days. About one to three days after symptoms begin, people generally develop rashes and raised lesions, which eventually crust over and form scabs that fall off. Overall, symptoms can persist for up to four weeks.

Marco has found his and his partner’s symptoms to be different from what he has read on the websites of public health agencies.

“You know how when people start getting symptoms, they’ll go to Dr. Google,” Marco said. “And you see the signs and symptoms, but nobody is saying that the signs and symptoms can vary.”

People infected with monkeypox can have a rash that begins on the face before spreading to other parts of the body, according to the CDC.

Marco noted that neither he nor his partner developed a rash. “The rash is supposed to turn into pustules all over the body,” Marco said. “That didn’t happen to us, either, except for maybe under my tongue.”

Monkeypox is not a “gay disease” and the potential for stigma is a concern

Marco asked us to use his first name only to avoid a potential stigma of the diagnosis for him or his partner, but he also wanted to share their experiences to prevent further spread of the virus.

Stigma is built into the LGBTQ+ experience.

HIV/AIDS has been closely associated with queer men since the epidemic’s rise in the 1980s. Some have concerns that monkeypox will follow the same path. This year, UNAIDS, the international HIV/AIDS organization, released a statement about the stigmatizing effects of referencing LGBTQ+ people, as well as African people, in public communications about monkeypox.

In addition to causing social harm, UNAIDS also warned that such associations could result in more problems for public health. The program’s deputy executive director, Dr. Matthew Kavanagh, said in the release, “Stigma hurts everyone. Shared science and social solidarity help everyone.”

Others say concern about stigma is less important when public health is at stake. Historian Jim Downs recently wrote a piece for the Atlantic titled “Gay Men Need a Specific Warning About Monkeypox.” In that piece, Downs writes, “Giving gay men carefully tailored warnings about monkeypox risk can be a form of education, not a form of stigma.”

Peter Staley, one of the original members of the HIV/AIDS activist organization ACT UP, agrees. He said that queer men will always experience stigma, whether it’s through rhetoric surrounding monkeypox or otherwise.

“The right is going to attack us for everything and anything they can. They always have and they always will,” he told BuzzFeed News. “We should never let that dictate how gay men talk to each other about health and risks.”

Staley fully acknowledges that communicating risk about monkeypox carries the possibility that the broader public could associate the virus with queer men, thereby creating a stigma.

“You have to fight two battles at once. We need to get the word out to gay men through targeted messages. And we need to be ready to fight the resulting stigma by delivering messages tailored for the general public.”

Just weeks after the first US case was reported on May 19, targeted messages about monkeypox are already reaching queer men in the country. Such agile communications are possible through existing infrastructures paved through campaigns to reach LGBTQ+ folks for the prevention of HIV/AIDS and other STIs.

Given that June is Pride Month, the CDC acted quickly to dispatch its director of HIV/AIDS Prevention, Dr. Demetre Daskalakis, to engage with organizations and health groups to get the word out about monkeypox. He and his team have plans to speak with multiple Pride organizers this week. Daskalakis said that this summer’s gatherings can be considered more opportunity than risk.

“I believe that Pride is an excellent opportunity to educate people. And when I think about our advice, it’s really about giving people the knowledge that they need to navigate events that can happen all summer, whether they go to Pride or not,” he told BuzzFeed News. “I tend not to think of places as risky environments, because it’s really about mitigating your own risk, to have the right information to be able to navigate what you’re willing to do.”

Daskalakis believes this surge of monkeypox has more parallels to a 2008 outbreak of MRSA, an antibiotic-resistant staph infection, than the HIV/AIDS pandemic that began in the ’80s. The so-called flesh-eating bacteria initially spread among clusters of queer men before leaping to the general population.

“It’s so similar in that it’s spread by really close contact. Sex could be one reason that there is close contact, of course, or other intimacy,” Daskalakis said.

Back then, like now, agencies issued similar warnings through healthcare providers, specifically those focused on HIV/AIDS, who had more queer clients. That was before the advent of smartphones and location-based dating apps. Now, the conversation has expanded.

Grindr, the most popular of these apps, has issued multiple information warnings about monkeypox. The app blasted the inbox of every user in the US, Canada, and most European countries with a message written by a local health agency and a link for more official information from a source in their country.

“We are not a public health authority, but we are excellent connective tissue,” said Patrick Lenihan, Grindr’s vice president of communications. “Our users want this information, and these groups want to distribute it to keep this population safe.”

In the US, Grindr is working with a group called Building Healthy Online Communities, which aims to provide targeted messaging about sexual health by bridging public health professionals and dating apps. The app has connected with the Public Health Agency of Canada to deliver warning messages to its users.

What to do if you think you have monkeypox

 

Provided to BuzzFeed News

A monkeypox bump is visible under the tongue of a Canadian citizen.

Public health experts recommend talking with all sexual partners and avoiding intimate contact if you have or your partner has had any recent illnesses, rashes, or lesions. If you or your partner think you have monkeypox, stay home, isolate if possible, and call your doctor.

Back in Alberta, Marco and his partner, who are typically very social, have been isolating at home awaiting results of their lab tests. Although they both tested positive for monkeypox, they are now waiting for confirmation from an infectious disease lab in Winnipeg, which will take a few more days to come back.

He has continued to send BuzzFeed News updates of their progress. The day after the couple went in for testing, Marco noticed two new lesions on his chin in addition to the sore under his tongue. Another day later, he woke up with a fever and another lesion, this time on his hand.

His partner has been feeling much better; his fever subsided and he has a little lingering pain from the lesions.

Marco said he understands how a disease like monkeypox could spread quickly among queer men, but he hopes that everyone — however they identify — will educate themselves on what to look for and how to protect themselves.

“We’re naturally closer and more affectionate. We don’t have that toxic mentality where we don’t hug or kiss each other,” Marco said. “But just because it started in the gay community, that doesn’t mean that’s where it’s going to stop.”