For pioneering AIDS activists, the monkeypox outbreak is provoking déjà vu

Four pioneers in the AIDS activist movement watch the global rise in monkeypox with awe and a sense of nostalgia.

Some of the similarities between the two viruses speak for themselves. Like the HIV strain that started the AIDS pandemic in the late 1970s, the current monkeypox outbreak originated in sub-Saharan Africa and has been found predominantly in men who have sex with men living in the world’s metropolitan areas. And while epidemiologists don’t yet have a full understanding of how the current monkeypox outbreak is spreading, recent research points to sexual transmission.

Four seminal AIDS activists of the 1980s and 1990s contend that there are other more momentous but less obvious parallels playing out in real time.

PICTURED: People hold up signs depicting the number of AIDS victims at a demonstration in support of AIDS victims in Central Park in New York City on August 8, 1983.
During a demonstration in Central Park in New York City on August 8, 1983, people hold up signs depicting the number of AIDS victims. Allan Tannenbaum/Getty Images file

As in the early days of the AIDS crisis, they argue, government messages surrounding the outbreak have been flawed, gay men have been caught unawares and public health officials have failed to defeat a serious disease affecting LGBTQ community plagues.

“It feels like déjà vu,” said gay rights activist Peter Tatchell, who was a leading member of the UK’s Gay Liberation Front. “The lessons of the AIDS crisis and Covid have clearly not been learned.”

Health authorities around the world were slow to fight AIDS when it first emerged in men who had sex with men in the late 1970s. It was not until June 5, 1981, that the United States published the world’s first government report on the infectious disease in the Morbidity and Mortality Weekly Report, a government bulletin about confounding cases of the disease.

“From October 1980 to May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at 3 different hospitals in Los Angeles, California,” the report said. “Two of the patients died.”

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Three years later, the US government announced the development of an AIDS test in addition to a vaccine that never materialized. By 1985, an estimated 12,000 Americans had died from the disease.

Similarly, activists argue that the global response to domesticated monkeypox has been too slow to contain the rising case numbers — more than 20,500 cases in the current monkeypox outbreak reported worldwide in 77 countries and territories as of early May, according to the Centers for Disease Control and Prevention.

No one has died from monkeypox outside of the 11 African nations where the infectious disease has become endemic since it was discovered in 1970. However, a significant proportion of patients infected with monkeypox have been hospitalized because of the severe pain caused by pimple-like sores that often develop.

Since the first cases were detected in May, the United States has distributed nearly 200,000 Jynneos vaccines – a two-dose vaccine to prevent smallpox and monkeypox – to the most vulnerable population, which lags far behind its approximately 3.8 million gay men . In France, only an estimated 6,000 people have been vaccinated in more than 100 vaccination centers in recent weeks, French Social and Health Minister François Braun said on Monday. And in the UK, health officials ordered a further 100,000 doses of vaccine last week to keep up with rising demand.

Last Saturday, the World Health Organization declared monkeypox a public health emergency of international concern, a designation reserved for the most threatening global disease outbreaks, after initially abandoning it last month. More than two months after the first case of monkeypox was discovered in the United States in mid-May, public health officials in New York City on Thursday issued a statement saying the infectious disease posed an imminent public health threat, and officials in San Francisco declared a state of emergency.

“What’s interesting is that many of the scientists and clinicians who were trained during the AIDS epidemic or were there from the start, people like Tony Fauci, know this story, but the response to monkeypox has been alarmingly slow and chaotic,” said Gregg Gonsalves , who joined Act Up in 1990 – the leading group fighting for action to end AIDS – and is now a professor of epidemiology at the Yale School of Public Health. “As an individual, it’s like, ‘Three strikes, you’re out, man.’ HIV, Covid and now monkeypox? How many times can you make the same mistakes over and over again?”

Representatives from the National Institute of Allergy and Infectious Diseases, which Dr. Anthony Fauci has been at the helm since 1984, and White House officials, where Fauci serves as the president’s chief medical adviser, did not immediately respond to NBC News’ requests for comment.

pictures of men wait in long lines outside of clinics around the world to get vaccinated, technically expenditure with online vaccine portals and reports accusing the US government of a “let’s wait and seeResponse to the outbreak — they have reportedly only called for shipments of vaccines as cases have surged in recent weeks — have compounded fears from activists that the public health response to monkeypox is a repeat of their flawed strategy to control Combat develops AIDS.

People queued outside the Department of Health & Mental Hygiene clinic in New York on June 23, 2022 as NYC provides vaccines to residents who may be exposed to monkeypox.
People lined up outside a Department of Health and Mental Health clinic in New York on June 23.Agency Tayfun Coskun/Anadolu via Getty Images

Although the virus began to spread in May, it wasn’t until June that the US ordered more doses of the monkeypox vaccine to expand its supply. Regulators had also just finished inspecting a key Danish monkeypox vaccine manufacturing plant in July, leaving 1.1 million doses ready for distribution in Europe stuck.

“Just like during the AIDS pandemic, some governments seem to care very little as long as monkeypox only affects men who have sex with men,” said Tatchell, who was turned away from a London hospital that had run out of monkeypox vaccine last Sunday. “What other explanation can there be? Governments should have introduced emergency vaccination programs for gay and bisexual men two or three weeks ago.”

Some veteran AIDS activists also argue that messages to fight monkeypox, as they were during the AIDS crisis, were not tailored enough to reach the LGBTQ community.

Ron Goldberg, an early AIDS activist who joined Act Up in 1987, points to the “America Responds to AIDS” public awareness campaign that the government launched in the late 1980s at the height of the crisis. Many of the commercials featured heterosexual couples and featured messages such as “AIDS is everyone’s problem.”

“Back then, they were so afraid to talk about gay sex or anything like that that if they tried to give information, they had to drown out the message,” Goldberg said. “If it’s happening within a specific demographic, you need to target your messages to that specific demographic.”

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Activists have largely welcomed efforts by public health officials not to directly link monkeypox to the LGBTQ community — as many believe they did to AIDS — thereby creating a stigma. However, some argue that repeated statements by public health officials that “Anyone can get monkeypox‘ echoes the AIDS message that ‘anyone can get the AIDS virus’ and also sidesteps efforts to warn the most vulnerable population.

Research overwhelmingly suggests that the current outbreak of monkeypox is predominantly caused by men having sex with men. A study published last week in the New England Journal of Medicine found that of the 528 cases of monkeypox analyzed by researchers, 98% were found in men who identified as gay or bisexual. Another recent report by the British Health Security Agency finds that of the 699 monkeypox cases for which information was available, 97% were gay, bisexual or other men who have sex with men.

“The numbers are there,” said Didier Lastrade, who founded Act Up’s first French section in 1989. “We shouldn’t shy away from that. … We are big people, we are adults, we can take it. The stigmatization happens one way or the other.”

On Thursday, the WHO recommended gay and bisexual men limit the number of sex partners they have to protect themselves from monkeypox and limit its spread.

But combined with two years of pandemic isolation and big summer events, like last weekend’s annual Pines Party on Fire Island, some activists fear getting gay and bisexual men to limit their sexual behavior will be difficult.

“You want to be able to reach out to people in their 20s and 30s and say, ‘Look, this is no joke. You’ve all seen the pictures. They all had friends who had monkeypox. You don’t want it,’” Gonsalves said.

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More broadly, Lastrade argued, the advent of pre-exposure prophylaxis, the HIV prevention pill (aka PrEP), coupled with scientific evidence over the past decade that treating HIV can prevent transmission, has led to gay and bisexual men fall asleep at the wheel when it comes to their sexual health.

“The new generation has completely forgotten the history of AIDS. I keep writing books about AIDS, but nobody reads them,” said Lastrade. “When it happens, they forget their reflexes that we used to have because it was a matter of life or death.”

Regardless of the message, activists fear that with a lackluster global rollout of vaccines, the virus will become an infectious disease that the LGBTQ community will have to live with permanently, as it did with AIDS decades ago.

“A lot of people are saying that we’ve passed the point of containment, that we’ve already missed our chance,” Gonsalves said. “If that’s true, it’s incredibly serious, because this disease doesn’t necessarily kill, but the tremendous suffering and cost of it all will weigh on many, many people, many, many health systems and many, many communities that have already been plagued.”

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https://www.nbcnews.com/nbc-out/out-health-and-wellness/pioneering-aids-activists-monkeypox-outbreak-evokes-deja-vu-rcna40523 For pioneering AIDS activists, the monkeypox outbreak is provoking déjà vu

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