The first major peer-reviewed study of monkeypox infections has found that the virus is primarily being transmitted through the sexual activity of gay and bisexual men in the United States and around the world.
The study reported on 528 infections diagnosed between April 27 and June 24, of which 98 percent were in gay or bisexual men with a median age of 38. Of these cases, 95 percent of the infections were suspected to have been transmitted through sexual activity—41 percent also had HIV.
Disease experts and officials from the U.S. Centers for Disease Control and Prevention (CDC) don't consider monkeypox a sexually transmitted infection but have always said it could be transmitted through intimate contact, such as sex. It can also be spread by close contact and even infected clothing and bedding.
Most of the cases appear to be in North America and Western Europe, where some of the first cases were linked to major LGBT events in Spain and Belgium, considered ground zero for facilitating transmission of the virus.
The leading theory among disease experts is that the monkeypox virus was sexually transmitted at those events.
Former Trump Health Officials Blame CDCCDC officials were hesitant to recommend canceling marquee U.S. LGBT events, similar to the super spreading events in Europe that occurred the month prior.
LGBT event organizers were also treading carefully in the spring, wanting to avoid stigmatizing the LGBT community. U.S. health officials opted instead to boost targeted messaging to warn gay and bisexual men, who were deemed most at risk.
But officials should have done more, says Dr. Paul Alexander, a former Trump administration health official and researcher.
"All this needed was leadership saying no skin to skin contact, no anal sex, no sex, none for a few weeks and we would have helped this high risk group, but no, it’s political games and now the low-risk general heterosexual population is at risk especially from bisexual males," Alexander wrote in a blog post.
The blog post also included a Twitter thread by a gay U.S. man recounting in graphic detail his experience with contracting monkeypox during an orgy in Palm Springs.
"Heterosexuals could spread this if one partner is infected and there is rough abrasive sex that involves tearing of tissue," Alexander added.
"This is not about being ‘gay,’ the virus is transmitted in bodily fluids and infected pustules and lesions in the infected person, through any tears on the skin or tissue e.g. rectal micro lesions etc," he continued. "If heterosexuals engage in anal sex and one is infected with monkeypox or another [sexually transmitted disease], the other will get infected if there is tissue tearing."
Although monkeypox infection generally clears up within a couple of weeks without the need for medical treatment, it has hospitalized some who experience severe anorectal pain, severe sore throats, and acute kidney injury.