The shortage of vaccines, fear combined with ignorance and the rebirth of stigma about the group of gay and bisexual men is the trail that also leaves behind, at least in Spain, the outbreak of monkeypox detected in more than 70 countries. Experts and patients agree that the most important thing to stop the spread of this virus is that more vaccines arrive. At the moment, in our country two people have died with the infection.
Spain has received a total of 5,300 vaccines to fight against monkeypox, which have already begun to be injected at different rates depending on the communities. For example, Madrid has put 790 vials, while in Aragon not one has been administered. At the moment, Spain is waiting for more doses, specifically 7,200, which will arrive in a few days, as confirmed to this newspaper by the Ministry of Health. But while they arrive, the infections continue to occur, while also spreading the stigma reminiscent of the shadows that brought with them the worst moments of the HIV epidemic four decades ago.
Daniel, a 34-year-old architect who lives in Madrid, assures that there is a lot of misinformation about monkeypox and that this is what has increased the stigma and fears. “As there is no direct information channel, from people who are alerting knowingly, we are looking for information on our own. Depending on where you read, it looks like one thing or another,” he comments.
Like many other people, Daniel still has questions about whether or not he should get vaccinated. “I took it for granted that it was impossible to get infected by taking off your shirt at a party, but my partner is more worried. We don't have sex with other people, but we do like to party." "We know there is a danger, but we don't know how we can minimize it," he acknowledges.
The idea that this is a disease that only affects men who have sex with men is wrong. Monkeypox is not a sexually transmitted disease, it is spread by close skin-to-skin or mucosa-to-mucosa contact. Is it possible to get infected in the Metro? And at a music festival? Experts insist that nothing is impossible and that is one of the many lessons learned from the coronavirus pandemic. “The contact must be intimate and prolonged. What can happen at a concert? It can happen. But it is more difficult”, recognizes the epidemiologist Mario Fontán.
Fontán, like all the experts consulted, believes that the key to stopping the spread of the outbreak is vaccines. “It seems that for the moment it is something that affects men who have sex with men, which is a somewhat limited term for other realities, the emphasis has not been placed as it would have been if it affected the entire population. world, as with COVID-19”, he criticizes. “Now that the WHO has declared it an international health emergency, it seems that a greater effort will have to be made. If this is not done, the risk of more people being affected will increase and it will affect other people and even the vulnerable.” Now it's up to governments to put in place measures that hinder contagion. For its part, the WHO launched a series of recommendations dividing it into four groups of countries.
Getting vaccinated is not an easy task. This is how Javi, a 30-year-old boy who now works in a housing project for the homeless, tells it. According to his account, he has tried several times to get an appointment to get vaccinated, but reports that the appointments end very quickly. “I found out from a friend that they were already giving appointments on the Community of Madrid website, but the appointments sell out in seconds or minutes,” he explains.
"A couple of times they have told me that there are appointments at that time and I have gone half an hour later and there were no more," he protests. "Accessibility is very low or nonexistent." Until this Tuesday, the Community of Madrid has confirmed a total of 1,925 cases and has administered 790 doses of the 1,835 received. As was the case with COVID-19, the self-appointment is the system chosen by the community for people to request the injection.
In Catalonia, for example, it is the health centers that come into contact with people who have "a high risk of contracting the disease", according to the Department of Health. The Catalan administration is contacting people who "maintain high-risk sexual practices included in PrEP programs for HIV or with HIV infection."
Close contacts of confirmed cases who, in case of contracting the disease, may have complications will also be vaccinated: girls and boys, pregnant and immunosuppressed people. Catalonia began vaccination against monkeypox on July 21, with 1,643 vaccines available, and as of the 29th of last month, 655 had been administered.
In Aragón, however, none of the 52 doses available have yet been administered, and in Castilla-La Mancha, SESCAM sources state that they have already begun to inject some of the 59 doses available. The Canary Islands are still waiting for their first 200 doses to arrive and "the vaccination points are already prepared to start inoculating", according to its Ministry of Health. In Galicia, four doses of the 138 available for the Servizo Galego de Saúde have been administered.
Alberto, a 31-year-old interior designer, has spent most of July locked up at home recovering from the infection. "This lasts longer than a day without bread," he says from the other end of the phone. "I would send a message to the institutions and that is to vaccinate as soon as possible, and also to the people, to sign up and get vaccinated," he encourages. Regarding the stigma generated, he sees it as normal that it has arisen because of how "the media has expressed it." “But a little consistency. You have to find out about the disease, know that it has nothing to do with sexual tastes”.
The FELGTBI+ federation calls for more vaccines and measures to stop infections, but also stigmatization. “After the WHO statement [que recomendaba a los hombres que tienen sexo con hombres reducir el número de parejas sexuales], a gigantic stigma has been generated, as we already anticipated, on the population of gay and bisexual men. A debate has been opened about whether the WHO is legitimate to talk about the personal and sexual relationships of the population, and we consider it unfortunate and out of place”, denounces Nahum Cabrera, HIV coordinator within the federation.
"We must bear in mind that monkeypox is a disease that is transmitted by contact, like measles or rubella," compares Cabrera, who asks that work continue on "vaccination lines." “This is a very old disease, we don't have to explain to virologists how to work. It was eradicated in the 1950s and we have plenty of technology to eradicate it,” he concludes.
Another consequence that stigmatizing a single group could have, as has been the case, is the creation of a false sense of security for the rest.
Pablo, a 34-year-old molecular biologist, has recently recovered from the infection. In his opinion, monkeypox “is just the tip of the iceberg of an underlying problem”. "As long as society continues to deny that people have a sexuality, this will continue to happen, it will continue to stigmatize more," he says.
“What I believe after having had smallpox is that socially you are not only rejected for being homosexual, but also for being 'vicious'. I think it is an opportunity to open up the debate on sexual freedom today, ”she adds, and understands that there are people who do not want to talk about it. “In fact, I have had problems coming to work after completing the quarantine. There are friends who do not want to stay with you. It's all very dramatic, but I don't care. I think that what needs to be done is precisely the opposite, to normalize it, ”she defends.