Why Aren't We Calling Monkeypox a Sexually Transmitted Infection?


I don't know. If transmission occurs when a penis goes into a rectum, regardless if live virus is in semen, that's a sexually transmitted infection (STI).  STI proctitis is a known condition, "Chlamydia, gonorrhea, herpes simplex virus (HSV), and syphilis are among the most common causes of sexually transmitted proctitis (1)." Add monkeypox. CDC is reporting over 7000 cases in the US, which most epidemiologists believe is an undercount. Why are case counts still increasing (see case curve below, data is subject to reporting lag)? Here's CDC's messaging from their website: "The monkeypox virus is spreading mostly through close, intimate contact with someone who has monkeypox (2)." Intimate contact? Is this supposed to be a euphemism for sex? Just say it plainly. We don't have to wait for science to prove monkeypox is sexually transmitted to act. It doesn't matter whether infectious virus is in semen. We don't need conclusive proof that people are able to transmit with minimal or no symptoms. Public health often errs on the side of caution to prevent disease. Schools were closed out of fear COVID-19 would spread among children. Maybe if the message is made clear people will alter their behavior and the epidemic will wane. Just say it. We can't wait for vaccine.

  1. Sigle GW, Kim R. Sexually transmitted proctitis. Clin Colon Rectal Surg. 2015 Jun;28(2):70-8. doi: 10.1055/s-0035-1547334. PMID: 26034402; PMCID: PMC4442722.
  2. CDC. 2022 Monkeypox Outbreak, viewed on August 4, 2022 from: https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html
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