Monkeypox and sexual transmission, after the words of the EDC on the subject – cases “have been diagnosed mainly among men who have sex with men, which suggests that transmission could take place during intimate relationships” – yes opens the debate on the possibility that it is a sexually transmitted disease, but also on the danger of a new ‘ghettoization’ of the homosexual community. Here is the opinion of Andreoni, Pregliasco, Iardino and Gismondo.
“It is a mistake to consider monkeypox a sexually transmitted disease. We consider this type of pathology when the infection occurs mainly through the sexual route and this is not the case of monkeypox which is transmitted by close contacts between people or by by air with droplets of saliva. It is obvious that any pathology that is transmitted with close contact sees in sexual intercourse a possibility that increases the infection, but we must be careful, otherwise we should consider chickenpox or measles or even Covid as sexually transmitted diseases”. Speaking at Adnkronos Salute is Massimo Andreoni, head of infectious disease at the Tor Vergata Polyclinic in Rome and scientific director of the Italian Society of Infectious and Tropical Diseases (Simit).
“The recent outbreak, which started from a party in the Canaries where there were males having sex with other males – he specifies – must not be the pretext to point to an entire community, otherwise there is the risk of creating a stigma as happened in the past. with HIV “. “We are seeing an increase in people going to the doctor’s office or emergency room suspecting they have monkeypox. There are currently no new cases, but this is an expected phenomenon when it comes to emergency diseases, and people do get suggestion. “continues Andreoni.
“But I would say that the opposite effect is more dangerous, namely that those who have a suspicion do not speak to their doctor and do not ask for information because they fear being pointed out and isolated. We have already seen this with HIV when it was associated with drug addiction or the homosexual community “, concludes Andreoni.
“Highlighting the objective characteristics of the current case history” of the monkeypox outbreak that is growing particularly in Europe “does not authorize, nor justify, stigmatizing or discriminatory attitudes towards anyone”. The virologist of the State University of Milan, Fabrizio Pregliasco, specified this to Adnkronos Salute. When we point out a case study of “all men except one woman, to date – underlines the expert – it means reporting” an objective fact “and on the part of the health authorities” it is not possible to do otherwise “. that “the risk is related to sexual contact in general”, as it is very close contact by definition. “The fact that in a proportion of males who have sex with males there may be greater promiscuity increases this risk”, adds the doctor.
Always sticking to “objectivity” without wanting to offer any alibi for “unjustifiable stigma”, and remembering that “transmission occurs in a demonstrated way also through droplets”, ie droplets emitted through the breath, Pregliasco observes that “the sexual act via anal facilitates the possibility of transmission of these infections because there are greater chances of contact with blood and lacerations. In monkeypox – the virologist notes – we know that the bubbles start from the face and classically involve the palms of the hands, unlike that in other infections, but they also affect the genitals. And obviously in any sexual contact these vesicles can rupture more easily. “
The cases of monkeypox “risk returning to ghettoize people for their sexual orientation. And it makes no sense. We start from the assumption that homosexual sexuality is different from the sexuality of the rest of the population. But some practices, in which a fragility is identified, they can be adopted in all couples, straight and non-straight. The great danger is that a segment of the population that has nothing to do with the transmission of the disease will return to ghettoize “. She explains to Adnkronos Salute Rosaria Iardino, president of The Bridge Foundation, that she began her battle against discrimination with the famous kiss to the immunologist Ferdinando Aiuti, HIV positive with AIDS. “I am of the opinion that as has happened for other sexually transmitted diseases, not just AIDS – continues Iardino – if we look carefully at the data, we find a greater frequency in the homosexual community because it is the one that goes to the hospital the most. , and whose cases are then reported. But there are many sexually transmitted diseases in the heterosexual population that are managed by the family doctor without being reported “, adds Iardino.
“What we can say – he continues – because it is scientifically proven that some sexual practices are more at risk. It is not people who are responsible. Sexual orientation does not cause disease, we must be clear. Also in this case the condom is a important protection tool. Prevention is needed in all those places where there is promiscuity “, he concludes.
“I reiterate that at this moment the risk for monkeypox is very low” also due to the self-limiting nature of the infection, “the cases are small” if dimensionally related to the population and “we must rest assured”. But above all, “we must absolutely avoid certain communication errors committed at the beginning of the HIV epidemic”. Maria Rita Gismondo, director of the Laboratory of clinical microbiology, virology and bio-emergency diagnostics of the Sacco hospital in Milan, underlines this to Adnkronos Salute.
“Having communicated the activation of the network of sexually transmitted infections at national and international level”, according to the expert, “has spread the idea of a sexual only transmission” of the ‘monkeypox’. Monkeypox “is certainly an infection that is transmitted through close contact and, obviously, sexual contact is one of the close contacts that can facilitate it. But we must not absolutely stigmatize this aspect – insists the microbiologist – and it is necessary to pay close attention to messages that are given and how they could be interpreted “.
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