On August 4, 2022, the U.S. Department of Health and Human Services declared the monkeypox (MPX) virus a Public Health Emergency. As of September 9, the World Health Organization reported 57,527 cases of MPX globally, with 21,893 of those in the United States. Almost all of the other cases were also in countries that have not historically reported the virus. Additionally, while MPX has been reported primarily among men who have sex with men, it is not limited to these groups, leading to its frequent mischaracterization as a sexually transmitted infection. In reality, according to the Centers for Disease Control and Prevention (CDC), MPX can be spread through many forms of close and personal contact with the rash, scabs, or body fluids from the infected person. While personal contact includes sexual contact, the CDC lists intimate contact including hugging, kissing, prolonged face-to-face contact, or touching objects or areas (bedsheets, towels, clothing) that may have been used by someone who has the virus and have not been disinfected.1 The recent reporting on monkeypox has included many homophobic references reminiscent of the coverage during the HIV/AIDS epidemic of the 1980s.
The Stonewall National Museum and Archives published an AIDS Timeline between 1981 and 2001, which includes examples of how leading organizations and media outlets depicted the gay community. Among them were a 1981 article in The New York Times written by Dr. Lawrence Altman entitled, “Rare cancer seen in 41 homosexuals”; a report published by researchers identifying AIDS as GRID, gay-related immune deficiency; and tabloid headlines like “Britain threatened by gay virus plague,” which appeared in the January 6, 1985, issue of The Mail on Sunday. Similar coverage continued for decades, with a barrage of homophobic images and stories that shamed and demonized the gay community. Like HIV/AIDS, monkeypox is not a “gay disease,” but it has been discussed in ways that may give that impression. Reminiscent of the media coverage early in the AIDS epidemic, headlines in various media platforms early in the monkeypox outbreak included “Gay Gatherings in Spain Being Blamed for Monkeypox Outbreak” (Guerrero, May 2022) and “Expert: Monkeypox Likely Spread by Two Sex Raves in Europe” (Cheng, May 2022). However, today social media has given people the ability to stigmatize and blame marginalized groups in seconds, in a digital imprint that is preserved in online posts, stories, blogs, and videos.
Erving Goffman (1963) referred to stigma as an attribute that was discrediting to an individual and was associated with a behavior or characteristic that deviated from social expectations. It’s important to remember that stigma causes significant harm to those being stigmatized. Racism and the MPX virus’s association with Africa compound the risk of stigmatization of marginalized groups. Since May 2022, media outlets such as BBC News and ABC News have been called out for their stereotypical, racist coverage. Specifically, they circulated old images, like one from the CDC depicting Black and African people with the disease from the outbreak in the Democratic Republic of the Congo during 1996–1997. A headline from Quartz Africa pleads, “Stop Using Images of Black People to Illustrate Monkeypox Stories” (Onukwue, 2022). Similarly, a CBS news story in July discussed the request that the New York City Department of Health sent to the WHO demanding the disease be renamed because the virus does not originate in monkeys, and the name can stigmatize communities of color. Most recently, the WHO has asked for the public’s help renaming the disease to minimize the stigma impacting both members of the LGBTQIA+ community and communities of color (Miller, 2022). Misinformation, stigma, and racism impact the safety and well-being of those targeted. We need only look at the number of hate crimes against Asian and Pacific Islanders who were stigmatized during the height of the COVID-19 pandemic to see the ways stigmatization can lead to violence in a public health crisis.
Today, experts in medical and public health fields know that during the first decades of the HIV/AIDS epidemic, stigma was a major barrier to the treatment and prevention of the disease. In light of this, it is hopeful to see leaders like WHO Director General Tedros Adhanom Ghebreyesus, who, perhaps in an attempt to avoid mistakes of the past, has responded to a call from a variety of advocates seeking to rename monkeypox, stating, “stigma and discrimination can be as dangerous as any virus.”
Questions for Discussion:
What are the dangers of stigmatization and labeling individuals or groups?
Discuss the positive and negative aspects of disseminating information about monkeypox through media/social media.
Suggest some ideas for public health announcements (PSA) about monkeypox, HIV/AIDS, or other diseases that would reduce or avoid stigma.
Can you suggest a new name for monkeypox?
Bratskeir, Kate. December 1, 2015. “This Is the First Story The New York Times Ever Wrote About HIV/AIDS.” Huffpost. https://www.huffpost.com/entry/first-story-about-aids-1981-new-york-times_n_565dc447e4b08e945fec9045
Centers for Disease Control and Prevention. September 10, 2022. “Monkeypox Outbreak Global Map.” https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
Centers for Disease Control and Prevention. July 29, 2022. “How It Spreads.” https://www.cdc.gov/poxvirus/monkeypox/transmission.html
Cheng, Maria. May 23, 2022. “Expert: Monkeypox Likely Spread by Two Raves in Europe.” https://abcnews.go.com/Health/wireStory/expert-monkeypox-spread-sex-raves-europe-84911559
Goffman, Erving. 1963. Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs, NJ: Prentice-Hall/Spectrum.
Guerrero, Desirée. May 24, 2022. “Gay Gatherings in Spain Being Blamed for Monkeypox Outbreak.” https://www.hivplusmag.com/world-news/2022/5/24/gay-gatherings-spain-being-blamed-monkeypox-outbreak
Miller, Madison. August 12, 2022. “The WHO is Renaming Monkeypox and Wants Your Help.” https://www.bloomberg.com/news/articles/2022-08-12/monkeypox-virus-who-asks-public-to-submit-new-name-ideas-in-online-portal?leadSource=uverify%20wall
Mills, C. Wright. 1959. The Sociological Imagination. Oxford University Press.
Onukwue, Alexander. May 24, 2022. “Stop Using Images of Black People to Illustrate Monkeypox Stories.” https://qz.com/africa/2169315/using-black-peoples-images-for-monkeypox-in-media-draw-backlash
Stonewall National Museum & Archives. October, 2020. “2020 LGBTQ History Month Stonewall National Museum & Archives AIDS Timeline – The First Twenty Years.” https://stonewall-museum.org/wp-content/uploads/HIV-AIDS-Timeline.pdf
U.S. Department of Health and Human Services. August 4, 2022. https://www.hhs.gov/about/news/2022/08/04/biden-harris-administration-bolsters-monkeypox-response-hhs-secretary-becerra-declares-public-health-emergency.html
World Health Organization. July 2022. “Public Health Advice for Gay, Bisexual, and Other Men Who Have Sex with Men on the Recent Outbreak of Monkeypox.” https://www.who.int/publications/m/item/monkeypox-public-health-advice-for-men-who-have-sex-with-men
World Health Organization. July 23, 2022. https://www.who.int/director-general/speeches/detail/who-director-general-s-statement-on-the-press-conference-following-IHR-emergency-committee-regarding-the-multi--country-outbreak-of-monkeypox--23-july-2022