Is monkeypox an STD? Experts dismiss the question as semantics: ‘The debate is kind of a distraction’

We now know that a large majority of the nearly 48,000 cases in the global monkeypox epidemic have occurred in men who have sex with men, that recent studies have identified the virus in semen, and that officials in the World Health Organization said last month it could be linked to “penetrating contact”.

But the kind of close contact that happens during sex and often spreads the virus can also happen outside of it. The presence of the virus in the semen does not mean that the liquid is responsible for the infections. And the WHO says it is still assessing how transmission occurs with a virus that appears to have recently mutated.

It is simply very difficult to distinguish close contact spread from sexual spread, epidemiologists say.

And none of that matters, not to the average person, anyway.

“At this point in the outbreak, the debate is kind of a distraction,” said David C. Harvey, executive director of the National Coalition of STD Directors. Fortune.

A nebulous category

Part of the problem here is that there is actually no single definition for sexually transmitted diseases or infections, experts say.

Whether or not monkeypox is an STI is largely a matter of semantics, say Harvey and other experts. The argument: whether the potentially deadly virus is simply sexually “transmitted” (it is, clearly) or whether it really is sexually “transmitted”.

“The definition of what an STI is is, quite honestly, quite arbitrary,” said Dr. Edward Hook, professor of infectious diseases at the Marnix E. Heersink School of Medicine at the University of Alabama at Birmingham. Fortune.

“You can get the flu from kissing or strep throat from kissing, but we don’t call them STIs,” said Hook, who is also a science adviser to the American Sexual Health Association.

Although rare, Zika and Ebola can also be sexually transmitted via genital secretions, “but we don’t consider them sexually transmitted,” Harvey said.

Some well-known STDs, such as herpes, syphilis and chlamydia, are not exclusively sexually transmitted and can be transmitted through other means, such as through childbirth, Harvey pointed out.

And another disease commonly thought of as an STD, hepatitis C, is actually rarely sexually transmitted and is more often transmitted through other means, such as sharing needles while using drugs, Hook pointed out. .

A double-edged sword

There’s some benefit to reporting monkeypox as an STD: Some insurance policies require free diagnosis and treatment, Hook said, a significant benefit for those who wouldn’t otherwise be able to afford treatment. , as well as public health and safety.

But there’s also a downside: stigma, which hampers efforts to prevent monkeypox and all STIs, to be frank.

“America in particular has a problem with gender and sexual health stigma,” Hook said. “It prevents people from seeking treatment. This makes patients reluctant to request tests and give [medical] the story, and therefore promotes continuous transmission.

Stigma doesn’t just keep patients from talking, it keeps doctors from asking questions. Health care providers can choose not to ask patients about their sexual history or test for sexually transmitted diseases if they are not comfortable talking about sex, he added.

“For these reasons, the United States has the highest rates of STIs traditionally reported as gonorrhea and syphilis in the entire Western world, despite spending more money” on the issue than any other region, did he declare.

Monkeypox is clearly sexually associated, experts say. The focus should be on educating the public with accurate information, through candid conversations. Time shouldn’t be wasted splitting hairs.

“I think what we need to focus on these days is how we’re going to beat this epidemic,” Harvey said. “And that means not getting carried away with the term, avoiding stigma, and explicitly educating people with the information they need to protect their health.”

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