Mon. Sep 26th, 2022

NEW DELHI: About two months before India officially reported its first cases of monkeypox, Mumbai doctor Ishwar Gilada he urged two of his patients to get tested. Both a gay man and a man who identifies as bisexual refused, even though their sexual partners had contracted the disease.
Gilada, who opened India’s first AIDS clinic in 1986, understood the challenges ahead. In parts of the world where LGBTQ people face stigma and prejudice, patients are reluctant to seek testing or treatment for a disease that has recently affected gay and bisexual men. They did not want to be the first. Monkeypox cases in IndiaGilada remembered. “They are going underground.”
Since May, the disease has affected more than 28,000 people, and while it can spread through all kinds of close contact, among cases in the US contact during the three weeks before symptoms appeared, they reported Friday. the Centers for Disease Control and Prevention.
India’s official count is nine cases, according to
social stigma
In countries where homophobia and life-threatening discrimination are rife, many people may not seek help, World Health Organization director-general Tedros Adhanom Ghebreyesus warned, “making the outbreak that much more difficult.” to track and stop”.
In India, stigma remains a pervasive social barrier. The country decriminalized homosexuality in 2018. The same year, a survey of 290 students attending the Calcutta National Medical College in Kolkata found that although general attitudes towards homosexuality were positive, 16% believed that homosexuality was a disease and 27% saw it as “learned behavior.”
That may have been a consideration for a 22-year-old man who tested positive for monkeypox in the United Arab Emirates in mid-July, days before returning home to India, where he experienced a fever and swollen lymph nodes. He was hospitalized in Thrissur, a city in the southern Indian state of Kerala, and developed brain swelling and required respiratory support before he died. He was already in critical condition when the patient’s relatives told hospital staff about his monkeypox diagnosis.
Priya Abraham, director of India’s National Institute of Virology, said the patient’s previous health must be investigated and other causes of death ruled out before the case can be considered a monkeypox fatality.
Counterproductive virus?
To look for additional cases of monkeypox, health authorities have implemented the wide-network contact tracing methods used to trace people exposed to Covid-19. Twenty people, including family, friends, domestic staff and people with whom the deceased patient had played soccer, were identified as “high-risk primary contacts”. Another 165 who traveled on the same plane were told to watch for symptoms.
In the context of monkeypox, where infections currently occur primarily through sexual networks, contact identification is a sensitive issue, especially if it forces people to reveal their sexual orientation, Gilada said. “They’re contact tracing every ‘Tom, Dick and Harry’ they’ve come into contact with,” she said. “You’re identifying people indirectly.”
Genetic sequencing of virus samples from other patients in Kerala indicated that monkeypox may have been circulating in the state for some time before it was reported.

In Africa, the only continent where the virus has been endemic for decades, infections are mainly the result of domestic transmission, not sex between men. Women account for about 40% of cases there, because they are usually the ones caring for the sick, said Patrick Otim, health emergencies officer for the WHO Africa region.
‘relationship of trust’
In India and other countries where men who have sex with men, or “MSM,” face discrimination, sensitive and non-judgmental public health campaigns are needed to help persuade people to come forward for testing, Sanjay said. Pujari, director and chief consultant of the Institute of Infectious Diseases in the city of Pune, in western India.
Cases will be reluctant to provide information about their contacts unless a “relationship of trust” has been established, he said. “Community engagement, including MSM organizations, must be included in the planning and implementation of the entire public health response to monkeypox.”
Many nations have yet to include this in their testing strategies or public awareness campaigns, though the outbreak is almost certain to spread, according to Nikolay Lunchenkov, health coordinator for the Eurasian Coalition on Health, Rights, Gender and Sexual Diversity, which works on access to health treatment for gay men, other men who have sex with men, and transgender people.
“Stigma is likely to only make things worse and prevent us from ending this outbreak as quickly as possible,” he said.
What’s more, the mislabeling of monkeypox as a “disease of homosexuals” is tragically reminiscent of the demonization gay men were subjected to when HIV emerged more than 40 years ago, Milka Sokolovic wrote last month, Director General of the European Public Health Alliance.
“This leads to an instant branding of us against them, allowing stigma and discrimination to rear their ugly heads once again,” he said. “We must not forget how labeling HIV infection as a homosexual disease during the HIV/AIDS pandemic in the 1980s caused unspeakable suffering in homosexual communities.”

Read More: Monkeypox cases driven ‘underground’ by anti-gay stigma in India | India News