BARCELONA, Spain (AP) – A sex worker and adult film actor, Roc was relieved to be one of the first Spaniards to receive a monkeypox vaccine. He knew of several cases of men who have sex with men, the main demographic for the disease, and he feared he could be next.
“I went home and thought, ‘Pfoe, my God, I’m saved,'” the 29-year-old told The Associated Press.
But it was already too late. Roc, the name he uses for his work, had been infected by a client a few days earlier. He joined Spain’s steadily increasing number of monkeypox infections, which have become the highest in Europe since the disease spread beyond Africa, where it has been endemic for years.
He began to show symptoms: pustules, fever, conjunctivitis and fatigue. Roc was hospitalized for treatment before he was well enough to be released.
Spanish health authorities and community groups struggle to control an outbreak that has already claimed the lives of two young men. They reportedly died of encephalitis, or brain swelling, which can be caused by some viruses. Most cases of monkey pox cause only mild symptoms.
Spain has had 4,577 confirmed cases in the three months since the outbreak began, which have been linked to two raves in Europe, where experts say the virus was likely spread through sex.
The only country with more infections than Spain is the much larger United States, which has reported 7,100 cases.
In total, the global monkeypox outbreak has seen more than 26,000 cases in nearly 90 countries since May. There have been 103 suspected deaths in Africa, mainly in Nigeria and Congo, where a more deadly form of monkey pox is spreading than in the West.
Health experts emphasize that this is not technically a sexually transmitted disease, although it has spread primarily through sex among gay and bisexual men, who account for 98% of cases outside Africa. The virus can be transmitted to anyone who has close physical contact with an infected person, their clothing or bedding.
So part of the complexity of fighting monkeypox is striking a balance between not stigmatizing men who have sex with men while ensuring that both vaccines and pleas for greater caution reach those who are currently most at risk.
Spain has distributed 5,000 injections of the dual vaccine to health clinics and expects to receive 7,000 more from the EU in the coming days, the health ministry said.
To ensure that those injections are administered wisely, community groups and sexual health associations targeting gay men, bisexuals and transgender women are leading the way.
In Barcelona, BCN Checkpoint, which focuses on AIDS/HIV prevention in gay and trans communities, is now reaching out to at-risk groups to offer them one of the precious vaccines.
Pep Coll, medical director of BCN Checkpoint, said the vaccine rollout is targeting people already at risk for HIV and receiving preventive treatment, men with a large number of sexual partners and those who participate in “chemsex” (sex with the use of drugs), as well as people with suppressed immune responses.
But there are many more people who fit into those categories than doses.
“If we just look at the number of people (with HIV prophylactic treatment) plus the number of people living with HIV, we’re talking about 15,000 people (in Barcelona alone),” said Coll.
The lack of vaccines, which is much more serious in Africa than in Europe and the US, makes social public health policy critical, experts say.
As with the coronavirus pandemic, tracing contacts to identify people who may have been infected is critical. But while COVID-19 could easily spread through the air to anyone, the close physical contact that serves as the primary vehicle for monkeypox makes some people hesitant to share information.
“We have a steady stream of new cases and it is possible that we will have more deaths. Why? Because tracing contacts is very complicated because it can be a very sensitive issue for someone to identify their sexual partners,” said Amós García, epidemiologist and president of the Spanish Association of Vaccinology.
Spain says that most cases occur in men who have sex with men and only 5% are women. But García insisted that this will become equal unless the entire public, regardless of gender or sexual orientation, understands that having different sexual partners carries greater risk.
“The same thing happened with AIDS/HIV, when at some point the group of men who had sex with men was the most affected (before it spread to other groups), and that could be the path it takes if we are not able to to send a strong message to society,” said García.
Given the lack of vaccines and the problems with tracing contacts, there is more pressure to promote prevention.
From the outset, government officials have ceded the leading role in the “get-out-the-word” campaign to community groups.
Sebastian Meyer, president of the STOP SIDA association committed to AIDS/HIV care in Barcelona’s LGBTQ community, said the logic was that his group and others who like it would be trusted messengers with personal knowledge on how to improve health. warning home.
While community associations representing gay and bisexual men have bombarded social media, websites and blogs with information about monkeypox safety, Meyer says much remains to be done.
Meyer, who sits on Monkeypox’s advisory boards for both the Spanish national government and regional authorities covering Barcelona, believes fatigue from the COVID-19 pandemic has played a role. Doctors advise people with monkeypox lesions to isolate until they are completely healed, which can take up to three weeks.
“When people read to self-isolate, they close the web page and forget what they read,” Meyer said. “We just got out of COVID, when you couldn’t do this or that, and now, here we go again… People just hate it and bury their heads in the sand.”
Meyer said his group is currently brainstorming ways to revamp and relaunch their message.
“If you’re not selected for a vaccine, the answer is not to hope you get one,” he said. “The answer is to be more careful. That is much better than any vaccine.”
JOIN THE CALL