Thread by @Greg0wen

1/ Ok. Monkeypox. Let's go:
First of all - this landscape changes very quickly and there's not enough data from this current outbreak to make confident and bold statements but let's try to establish a few things where we can

2/ Monkeypox is NOT a sexually transmitted infection although it CAN be passed on during sex due to skin to skin contact. Similar to the way shigella is not an STI but can be passed on during sex. Monkeypox is NOT 'a gay disease' but this current outbreak is mainly

3/ in gay and bi men and other MSM (GBMSM) because it is predominantly being spread through sexual networks. It is therefore no surprise that big cities with large communities of GBMSM and dense/denser sexual networks are seeing larger numbers of cases eg London

4/ I want to state EXPLICITLY that I personally will never use a 'just don't have sex' message. I don't think it works and I don't think it benefits our community. But let's look at the basics and figure ways that we can mitigate our risks.

5/ we know that skin to skin contact is the main transmission route for MPX. So where will we find a lot of that? The main places I'd say (for sex + skin to skin contact) will be saunas, sex parties, and sex on premise venues. This is just math and logistics. Nothing else.

6/ No judgement here at all - certainly not from me (it would be a tad hypocritical on my part, no?). Beyond the risk from skin to skin contact - we know that the virus can live on hard surfaces for several weeks (up to 30 days) and on soft surfaces for much longer.

7/ so these spaces are going to come with a risk. And I fully believe in people establishing their own acceptable levels of risk. It is not for me (or anyone else) to dictate that. Now, let's talk about symptoms - most people WILL have symptoms.

8/ that's kind of a good thing when we think about trying to contain this outbreak (although not pleasant for the person experiencing these symptoms). Most people WILL have symptoms but NOT ALL people. A lot of focus has been on the rash/sores but it's good for people to be aware

9/ that you might well feel run down, fever, headache, muscle aches,swollen glands/lymph nodes, chills & tiredness BEFORE seeing any rash & to be aware of this. Some cases have reported no or few sores & some have reported internal sores eg throat & rectum - which we can't see

10/ worth pointing out - we need to be aware of our 'sexual networks' not just our own personal sexual activity. We've seen a bunch of cases where a sauna visit was the route of transmission but we've also seen cases where people have picked up MPX from a one-off oral sex hook up

11/ As GBMSM - our sexual networks are much denser than other communities. Again that's just math. But it's not just skin to skin contact from sex that people are worried about. People are rightly concerned about skin to skin contact from large public events like

12/ pride and festivals. These are environments where transmission can occur. There's no way to dress that up. It obviously carries less risk but there is still risk. I don't think we need to panic. Nor is it helpful. But I think we can definitely say that MPX is not

13/ going away any time soon and we are definitely not 'ahead' of this virus. Numbers are increasing exponentially. It's not always mild and about 10% of people will need to visit hospital. The vaccine programme is still being worked out at the moment. I don't have any firm

14/ details on that but demand is going to be higher than supply in the immediate term and will probably stay that way for several months. This is not just here in the UK. The US, and other European countries are in similar situations. There IS vaccine available,

15/ it just needs to be procured. So what can we do? Let's be honest - none of us wants to be dealing with this shit right now. We've just started to come out of 2 years of hideous Covid bullshit and restrictions on our lives. It will take time for us to recover from that.

16/ We've a 40 year history of living with HIV and we're constantly on alert for all the other STIs that we're constantly reminded of - I get it. It's exhausting and we're all tired.

17/ The obvious equation is *the less skin to skin to skin contact you have with other gay and bi men = the less your exposure to risk*

It's obvious but not always easy.

18/ Sex with lots of people and in spaces where there are lots of people having lots of sex with lots of people - obviously increase transmission opportunities.

But we don't always have sex like that. The type of sex we have and with whom is often ever-changing.

19/ So we're all in this together. If you have symptoms please follow guidance and established pathways. *Phone* a sexual health clinic or 111. They will advise you what to do. If you have a confirmed diagnosis or if you think you have monkeypox please isolate.

20/ Again, this is easier said than done. Not everyone will be able to do this and with no financial support in place for those who are required to isolate - we're in a difficult situation. But try where you can.

21/ There are so many brilliant people working on this across many organisations and on every level and they're trying their hardest to make this situation better. Finally - I really hope my track record speaks for itself - this isn't about blame or stigmatising people.

22/ Vaccine roll out will help but until then we need to do what we can to help curb this outbreak. Just be aware and be vigilant. And please be kind to people who have contracted monkeypox - especially if you've been in close contact with them.

23/ We need people to feel safe and supported so we can help them with contact tracing. People are much less likely to do that if they feel they are going to be attacked or judged. Let's not do that. THE END

I'll post some links to resources later today.

*premises

24/ This update has just arrived from @SparrowhawkAlex: Gay & bi men (GBM) continue to be significantly impacted by outbreak, accounting for ~96% of cases during in-depth surveillance. GBM currently need to be more alert of the symptoms, & what to do than the general population

25/ Information
Useful resources to sign-post communities to:
•tht.org.uk/news/monkeypox…
•i-base.info/monkeypox/
•queerhealth.info/monkeypox

26/ For colleagues - Monkeypox data from UKHSA (cases are currently updated Tuesdays and Fridays)
•Cases: gov.uk/government/pub…
•Technical briefings: gov.uk/government/pub…

27/ Vaccine
•Eligible GBM -contacted or offered the vaccine by their sexual health clinic
•London receiving a bigger allocation because ~80% of cases to date have been found there

*please don't contact sexual health clinics about vaccines atm as they are already overwhelmed

28/ Vaccine
•More doses have been secured but not yet in the UK, currently people will receive one dose, a second dose is expected to be offered

*I'll update this thread when more detailed information becomes available

29/ Some information on monkeypox vaccines (UK) from my friend @Matthew_Hodson (at @aidsmap @aidsmap_news)

https://twitter.com/Matthew_Hodson/status/1542825447272185858

30/ Some additional monkeypox vaccine updates from @TeamPrepster. This is the most recent information available (as of 1st July) for the UK.

I’ve been holding off making statements on ‘equalities’ & the lack of urgency around the health of gay and bi men BUT 👇

https://twitter.com/teamprepster/status/1542893468879659008