Medical journalist; science editor for @POZmagazine/@Hepatitismag/@CancerHealthmag; Bay Area Reporter (@eBARnews), @aidsmap/@infohep; research beagle adopter
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Aug 30 • 6 tweets • 2 min read
I think this is a terrible idea. As we saw many times with #COVID & now #monkeypox the accepted consensus can change -- & it should change as we get more evidence. Who's smart enough & prescient enough to decide what's misinformation? 1/ nytimes.com/2022/08/29/tec…
Yes, sometimes misinformation is obvious -- those are the easy cases.
- Is SARS-CoV-2 airborne?
- Were school closures beneficial or harmful?
- How common is long COVID?
- Is monkeypox an STI?
Just a few questions where experts disagree & our understanding has evolved. 2/
Aug 30 • 4 tweets • 2 min read
There's a new round of dis/misinformation about the safety of #COVID vaccines during pregnancy. While pregnant women weren't included in clinical trials (as is typical), hundreds of thousands have safely gotten the vaccines in the real world.
It's true children historically got #monkeypox in African countries where the virus is endemic. But until recently, MPX was considered rare. It was not thought to spread easily between humans & outbreaks were small. That's still the case for everyone *except* gay/bi/MSM. 1/
That remained true until an outbreak in Nigeria in 2017, when cases shifted towards young urban men. Dr. Ogoina (profiled here) & other experts think it might be transmitted sexually there as well (& not necessarily limited to sex between men). 2/ n.pr/3PPiCR5
Aug 29 • 5 tweets • 2 min read
Just to be clear, @WHO reports 140 people under age 18 with #monkeypox. @CDCgov reports <20 in US. There has been no known transmission in schools. Official data lags, but cases in children have remained well under 1% for 3 months. 1/
If MPX were going to spread like wildfire among kids — & if it were easily transmitted through casual contact or the air — surely we’d have started to see some indication of that by now. 2/
Aug 11 • 4 tweets • 2 min read
Gay men don't need government directives or community shaming -- just be honest about how #monkeypox is spreading (ie, don't suggest sex, dancing together & touching clothing are equal risks) & they'll figure it out for themselves. It's already happening. wapo.st/3PbtLuk
Behavior change didn't *fail* to curb #HIV -- rather it was an incomplete success, so we needed new approaches like U=U & PrEP. Until #monkeypox vaccines are readily available, abstinence, fewer partners, different activities & condoms are all part of the harm reduction toolbox.
Things we do & do not know about this case. We know a daycare worker has #monkeypox. We're told some number of young children were exposed. None of the kids have MPX so far, but the incubation time is too short. 1/ nbcnews.to/3zD0CT9
The reported exposure ranges from touching the same objects to possibly varying degrees of skin-to-skin contact. Some of these exposure risks are considered very low risk, others are higher. 2/
Aug 6 • 5 tweets • 2 min read
People on both ends of the political spectrum came to distrust public health & the media during COVID because they think mitigation policies were either too strict or too lax & we warned the public either too much or not enough. The same thing is happening with #monkeypox. 1/
Through COVID social media, I've been exposed to a wider diversity of viewpoints than I was used to. And the way people on the two "sides" are reacting doesn't look all that different. 2/
Aug 5 • 6 tweets • 4 min read
I have no idea what condition this person might have, but #monkeypox shouldn’t still be producing new lesions at 6 weeks, right? Is this a known phenomenon?
Like many of the women on social media claiming to have monkeypox, a quick scan of her posts doesn’t show her saying she actually tested positive. The lesions she photographs could be many things.
Aug 1 • 11 tweets • 6 min read
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
#Monkeypox vaccine messaging is difficult & conflicting because there's not enough research. Data so far is based on immunogenicity (essentially, antibody production) not real-world effectiveness. Starting with 1 dose is a good strategy to get more people some protection ASAP. 1/
But saying a single dose provides adequate protection is premature. In particular, people with #HIV have a lower response rate & it seems like they should be prioritized for 2nd doses. @dr_demetre says @US_FDA stands by its recommended 2-dose regimen. #AIDS2022 2/
Another article done, so off to final edition of #NoPantsNoProblem. End of an era -- this queer party has accompanied International AIDS Conferences for more than a decade. Proceeds fund global grants for HIV+ women. @gnpplus@Visual_AIDS 1/
Yeah, it's fraught to have a party of people, many of them HIV+, who've traveled from all over the world in the era of COVID & now #monkeypox. A lot of people won't feel safe going -- & that's completely understandable & rational. 2/
Important🧵from @thrasherxy. We've all seen the excerpts posted here from historical descriptions of #monkeypox transmission & symptoms, but the current outbreak among gay/bi/trans/MSM looks very different. 1/
It's quite possible low-level MPX spread is happening via traditional transmission routes while *at the same* time an explosive outbreak is occurring, via different routes, in a specific population. 2/
Jul 29 • 5 tweets • 4 min read
.@CAPublicHealth has released new #monkeypox data with some eagerly awaited demographics. Still overwhelmingly gay/bi/MSM. Among 786 cases are 5 trans men, 3 cisgender women, 3 trans women & 2 non-binary. 45% white, 36% Latino, 9% Black & 6% Asian. cdph.ca.gov/Programs/CID/D…
According to census.gov, #monkeypox distribution for Latino & Black people isn't that far off from statewide population percentages (40% & 7%, respectively. But other sources put the Latino population share much lower, at around 19%.
Jul 29 • 5 tweets • 4 min read
A Southern California man appears to be cured of #HIV after undergoing a stem cell transplant to treat leukemia, Dr. Jana Dikter of @cityofhope reported this week at #AIDS2022. @eBARnews ebar.com/story.php?ch=N…
This risky procedure isn't suitable for most people with HIV, it offers clues for more feasible approaches. "These cures are no longer anecdotal - we now have a real case series," said Dr. Steven Deeks of @UCSF . #AIDS2022
Jul 29 • 4 tweets • 3 min read
Annie Luetkemeyer (@annieluet) reports doxycycline PEP reduces risk of STIs for gay/bi men & trans women on #PrEP (incidence 32% vs 11%) & #HIV+ (31% vs 12%) — even more so for those who used it consistently. @UCSF#AIDS2022
DoxyPEP led to reductions in #gonorrhea, #chlamydia & #syphilis. Analysis of antibiotic resistance & gut microbiome is underway. #AIDS2022
Jul 28 • 8 tweets • 4 min read
SF declares #monkeypox a state of emergency. SF has a large & politically powerful LGBT community & one of the largest MPX outbreaks in the US on a per capita basis. 1/
SF was, I believe, 1st US city to issue an emergency & take steps like a shelter-in-place order for COVID. Not sure new emergency means in practice. What we need is more vaccines, but that’s up to the federal govt. 2/
.@CDCgov's latest COCA update on #monkeypox epidemiology, testing, vaccination & treatment. Now 3591 cases in US. 99% male at birth (possibly some trans women), 13 people female at birth (includes some trans men). All but 5 cases attributed to sex between men. 1/
These COCA updates provide a wealth of info. This one includes testing update (now capacity of 80K tests per week, but still only lesion swabs), revised simpler protocol for #TPOXX treatment. 2/