Stigmatization of Monkeypox to MSM can Overshadow the Other Risk Factors

Dear Chief Editor,

Soon after the pandemic, a new species of orthopoxvirus, that is the Monkeypox virus, is now a leading threat to the world, especially in the American, European and African regions where the highest number of cases are reported by WHO in 2022.¹ Few studies ruled out the fact that MSM (Men who have sex with men) societies are at the highest risk to get infected by Monkeypox as seen in European and non-European regions where male-to-male sexual relations are common.^2,3 Thus, sensationalizing the disease with just one group of people could overlook various other factors and traits that need attention for preventing Monkeypox.⁴

According to the recent WHO guidelines, it is a matter of fact that any kind of close contact with the infected person, animals, material contaminated with the virus, respiratory droplets, and body fluids can spread the disease. However, no definite mode of transmission is known till now.⁵ Since the outbreak is recent and has various aspects that need to be investigated, association with only one risk factor while overlooking the rest could lead to stigmatizing the disease. This could seriously affect all the other socially exposed groups who are for now equally at risk for this endemic. This could be supported by the fact that in the past, diseases like AIDs were also stigmatized to just one community and straight people were thought to be safe. However, with the advancement of the disease, the heterosexual community, especially women also accounted for some of the proportion of the affected individuals.⁶ Moreover, the monkeypox outbreak is not new as it has its history back in the year 1958 when the first case was identified from monkeys shipped from Singapore to Denmark in 1958, then a confirmed case was from a child in Democratic Republic of Congo in 1970. This was the time when the MSM society was not that prominent but still, the disease prevailed.⁷

The purpose of the above discussion does not devalue the importance of prevention of close contact, especially faeco-oral sexual activities during this endemic. However, it aims to consider a wider canvas for:

1. Investigating the disease and its prevalence by analyzing the various aspects and factors that are equally responsible for the disease and

2. Performing thorough research in different groups of the population to study different traits that could contribute to the spread of monkeypox

3. A definite prevention program based on possible risk factors should be channelized in the countries that are most affected, whereas the countries which are at risk should also be guided accordingly and lastly,

4. For the media and press to avoid sensationalizing the disease, as such practices were also seen during Covid-19, when the media was a strong source of developing fear rather than awareness among people.⁸