Monkeypox could signal dawn of a new STI in men as ‘uncontrolled’ global spread continues

Prof Jackie Cassell, a public health adviser and professor of urogenital medicine at the University of Sussex, with ties to the British Association for Sexual Health and HIV, told The Telegraph that the best way to understand how the virus spreads is is to bring back a covid classic – R, the reproduction rate.

If it’s greater than one, the breakout grows. Less than one and it’s shrinking.

“Sex keeps R above one during this burst,” she said. “You’ll get a few spillover exceptions, but those won’t keep R above one, and that’s why we’re still seeing – and can expect to continue to see – the overwhelming dominance of [monkeypox] among men have sex with men.”

If monkeypox hadn’t spread through sex in this community, the outbreak would likely have fizzled out by now.

For this reason, Dr. Tedros Adhanom Ghebreyesus, head of the WHO, on Wednesday urged men who have sex with men to “reduce the number of their sexual partners,” while Prof Francois Balloux, director of University College London’s Institute of Genetics, said: “It’s not a pathogen , which has the potential to become a sexually transmitted disease in the heterosexual population.”

Nevertheless, experts dig into the STI label. Why? Technology, history and stigma.

“Monkeypox is spread through sexual contact and other contacts as well, while other diseases are only transmitted through close sexual contact,” Prof David Heyman, an infectious disease epidemiologist at the London School of Hygiene and Tropical Medicine, told The Telegraph. “That’s the differentiator.”

Other STIs that spread through close contact — including herpes and syphilis — aren’t as effective at spreading outside of sexual contact, he added.

For example, although syphilis could “possibly” spread through skin-to-skin contact, the bacteria prefer “mucous membranes” like those found in one’s genitals. The monkeypox virus has now been detected in semen and saliva, but it is not yet clear how contagious it is.

Experiences in Central and West Africa, where the disease is endemic and 75 people died this year, have made experts reluctant to categorize it. Sexual transmission has not been identified as an important transmission route – although, according to Prof. Heymann, there has always been a suspicion that the virus tacitly exploits sexual networks.

“Whether something is sexually transmitted or not depends a bit on the context,” Prof Cassell added. “If you live in a village where people live in tiny little shacks and all the children sleep in the same room, then you’re going to get a lot of close-range transmissions.

“So it’s not the disease, it’s the way the disease is transmitted in a given environment. It’s not just about the pathogen, it’s about the pathogen in an environment.

“Broadly speaking, in this country, in this resource-rich environment, it’s sexually transmitted, with a few excesses,” she said.

“I could say that monkeypox is an incidental STI,” said Prof. Heymann. Monkeypox could signal dawn of a new STI in men as ‘uncontrolled’ global spread continues

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