Thread by @LizHighleyman

If you read just one #monkeypox article, make it this one, illustrating both the folly of not listening to people on the ground in the most affected communities & the perils of shaming & stigmatizing sex so much that people won't talk about it. 1/ @NPR

n.pr/3PPiCR5

This Nigerian doctor, Dimie Ogoina (@Dimostic) just addressed a special #monkeypox session at #AIDS2022. 2/

Historically, based on experienced in African countries where #MPX has been known for decades, the virus was often contracted from contact with rodents & was considered difficult to transmit from person-to-person. 3/

(This is the origin of the old @CDCgov travel advisory people are sharing, which suggests #MPX is transmitted via air or fomites more than skin-to-skin. Their new info better reflects our current -- & evolving -- understanding, but the internet never forgets...) 4/

Slow, low-level, containable spread was the pattern until #monkeypox made it into sexual networks, where it can spread like wildfire. (Whether that makes it an STI or not is an academic debate.) 5/

In 2017, cases in Nigeria shifted to young urban men without traditional risk factors. (Not necessarily gay/bi/MSM -- you could also see a predominantly male distribution if lot of men have sex with few women (eg, sex workers). But it was "don't ask, don't tell" about sex. 6/

"So there was a huge realization: The virus had changed. For the first time, it was spreading through sexual contact...this shift in transmission had massive implications. It meant the monkeypox virus could more easily spread from person to person..." @Dimostic @FoodieScience 7/

@Dimostic "tried to warn health officials and scientists repeatedly that monkeypox had changed and was possibly spreading through sexual contact. At one international meeting, he tried to bring up the possibility of sexual transmission. Somebody told him to be quiet." 8/

In the new epidemic outside Africa, some public health officials, LGBT advocates & well meaning straight allies are again urging a #DontSayGay or "Don't Say STI" approach. But acknowledging how & where #monkeypox is spreading is critical to addressing it. 9/

Dimie Ogonia (@Dimostic) speaks during #MPX session at #AIDS2022. Since cases started appearing in Europe & America, there’s been increased awareness & surveillance in Nigeria, but "we must ensure there is equity in the distribution of vaccines & therapeutics for #monkeypox."

Here's Ogoina's report on the 2017 #monkeypox outbreak in Nigeria, where cases shifted to primarily young urban men.

journals.plos.org/plosone/articl…