If there was not enough on our plates, monkeypox has been identified in gay men around the world. What fresh hell is this? Hopefully, this will not become an epidemic like HIV; however, there are reasons to be concerned. HIV service providers, STD clinics, and health departments need to be prepared to pivot as more cases are identified.

How does the HIV community educate about monkeypox and not stigmatize gay men? As we know, HIV is not a gay disease and gay men are the majority of people living with HIV. Our work must thread the needle between the need to educate gay men about monkeypox while not adding to the disease burden of a community traumatized by HIV, STDs, and Hepatitis.

The world has lots of judgements about people who are different. Between monkeypox, “don’t say Gay,” and the anti-transgender bathroom, sports, and school bills, it’s a tough time to be LGBTQ in America. The radical right feels emboldened to lie and label us as groomers in a not too veiled attempt to equate gay men to pedophiles. Have they no shame?

HIVphobia, homophobia, transphobia, racism, sexism, and ageism create the trauma that I believe are major contributors to why 49% of people living with HIV fall out of care and why overall enrollment for PrEP is so low. It’s not enough to offer services, even if they are free. There needs to be active and ongoing outreach to community that provides trauma informed care and prevention services. The CDC has developed six guiding principles to a trauma-informed approach.

The communities we need to reach are the same people who are traumatized because they live in America. COVID, Black Lives Matter, Jan 6, climate change, inflation, immigration, war in Ukraine, fires, baby formula shortages, elementary school shootings, crime, Asian violence, racist mass shootings, abortion, Supreme Court, monkeypox, and the upcoming midterm elections are the trauma impacting our family, clients, staff, donors, and government officials.

We’re trained to wait for the “other shoe to drop.” Monkeypox is just another on a long list of “what fresh hell is this?” Two years after the initial outbreak of COVID, we are still trying to figure out how to live in a world that has gone upside down. Too many Americans are suffering from some form of trauma, and many do not know how to cope. The trauma is coming from multiple sources/directions and feels never ending.

Not only do we need to support family, clients, staff, donors, and government officials, we also need to take care of ourselves. Do not minimize the stress and trauma of leadership while flying blind. The control queen in me is having a particularly difficult time. I’m learning to lean into the reality that I don’t have the answers. We are making the best decisions we can and there are too many unknowns to be definitive.

After my signature there is a resource list prepared by the White House on monkeypox. Given everything that is happening, it is comforting to know that the President stands with the LGBTQ community. We see it in his words and deeds. By the end of June, the Supreme Court will issue their much-anticipated ruling on abortion. Reproductive health and HIV are connected in our commitment to the sexual health and wellbeing of all Americans. Their fight is our fight.

Yours in the Struggle,

Paul Kawata

White House Monkeypox Resources
Social Media and Video Resources

General Information Web Resources

Healthcare Web Resources
2022 Monkeypox: Information for Healthcare Professionals | Monkeypox | Poxvirus | CDC
Case Definitions† for Use in the 2022 Monkeypox Response | Monkeypox | Poxvirus | CDC (updated 6/2/2021)