KUALA LUMPUR, Aug 9 — The World Health Organisation (WHO) had in July sounded the highest alarm for the monkeypox outbreak, calling it a global health emergency that disproportionately impacted queer men.

Despite cautions by WHO not to discriminate against the queer community, that alarm spiralled into a narrative that monkeypox is a disease that targets gay and bisexual persons.

According to the US Center for Disease Control (CDC), monkeypox can be spread to anyone through direct skin-to-skin contact from an infected person, non-direct contact (touching objects or surfaces that were previously contaminated by an infected person), respiratory droplets, or being bitten and scratched by an infected animal.

In other words, monkeypox is not a disease that only affects men who have sex with men (MSM), but an infection that can be transmitted to anyone regardless of sexual orientation or identity.

Small outbreaks of monkeypox are common in Africa; people have been infected through bites from rodents and small animals for years but outbreaks had not spilled beyond African borders.

But in May, cases began emerging in countries that have not previously reported monkeypox cases. The outbreak was traced back to sexual activities at two raves in Belgium and Spain.

From there, the virus found its way to other parts of Europe, the Americas and slowly hit the shores of Malaysia’s neighbouring countries such as Singapore which reported 11, and Thailand which reported two at the time of writing.

The dangers of biased media reporting on monkeypox

Some reporting of monkeypox in Malaysia has since linked the lesbian, gay, bisexual, transgender and queer (LGBT) community to the disease. Advocacy group Justice For Sisters (JFS) called out problematic reporting in two Malay-language news outlets.

In a media analysis it recently published and made available to Malay Mail, JFS said the problematic reporting included stigmatised translation and summarisation of the issue, lack of fact-checking, biased statements by experts, and the use of stigmatising language and terminologies.

The group’s co-founder S. Thilaga said the danger when defining monkeypox as a "gay disease” is that it tends to ostracise minority communities and might hinder efforts to identify infections and tame the outbreak

"Similar to Covid-19, it surfaces existing inequalities and disparities in our society. In the context of monkeypox, it surfaces several critical and interrelated issues,” she said.

"In Malaysia, the government and members of the public already exploit or misuse illnesses like HIV and even disasters to reinforce harmful misinformation that LGBTQ+ persons are sinners, and must be dealt with for the greater good,” the sexuality rights advocate at JFS said, adding that some might see monkeypox as a form of retribution for "sinning”.

"This in turn will result in low self-acceptance, reduced access to information and healthcare services, delayed treatment and support among LGBTQ+ persons, especially gay, bisexual and other MSM,” Thilaga said.

Watered-down medical treatment for stigmatised groups isn’t new.

A 2019 study by rheumatology expert Dr Tee Ying Chew found that stigma and prejudice against HIV was the leading factor in HIV-infected patients receiving poorer quality healthcare. Another factor was physicians’ fear of an increased risk of contracting HIV through work exposure such as surgery.

The monkeypox outbreak and its prevalence among gay men have raised concerns for a community still scarred by the long stigmatisation of the HIV/AIDS epidemic in the 1980s.

"The trajectory of infections with monkeypox follows the early trends of HIV/AIDS,” Dr Choong Sim Poey of Reproductive Rights Advocacy Alliance Malaysia (RRAAM) said.

"Like HIV, it was concluded that gay men tend to have more casual sex with multiple partners than heterosexual couples. Also, anal sex has a higher transmission rate compared with vaginal sex. It isn’t anything to do with God’s punishment on gay men,” he said.

How to protect yourself against monkeypox

Monkeypox has not reportedly reached Malaysia yet, but it is still good to have information on how to be safe from it.

Monkeypox, a relative of smallpox, can look like blisters, pus-filled bumps, or an open sore.

Its symptoms include fever, fatigue, headache, maculopapular rash that first appears on the face and later spreads to the arms and other parts of the body, body aches and back or joint pain, muscle spasm, and swollen lymph glands.

To help contain the outbreak, the US CDC says to avoid sex or being intimate with anyone with a new or unexplained rash on their body. If you are going to have sex, the CDC suggests virtual sex, masturbating together at a distance without contact, having sex with clothes on to reduce skin-to-skin contact, avoiding kissing, reducing the number of sex partners, and thorough washing of hands, toys, and fabrics.

According to a tally by the US CDC published on August 1, 2022, the CDC reports 23,630 confirmed monkeypox cases worldwide, of which 23,276 cases were reported in countries that have not historically had monkeypox.

The majority of the confirmed cases have been reported in Europe, the Americas and African continents.

Malaysia’s Health Ministry has also issued a directive for all inbound travellers from countries with reported cases of monkeypox to update their health status and monitor symptoms on the MySejahtera application regularly for 21 days upon arrival.

Previously, the Health Ministry also notified nine suspected monkeypox cases in Malaysia but all were confirmed to be negative.