The new outbreak of monkeypox, declared a global public health emergency by the WHO (World Health Organization) in July, raises a warning to sexually active populations. This is because the virus infects people through skin-to-skin contact and intimate objects — such as cutlery, clothes and blankets —, with sex being a time of great exposure to risk. With that, the question arises: is there a safe way to keep sex life active amid the monkeypox epidemic?
Before answering this question, Tatiana Batista, an infectious disease specialist at the Municipality of João Pessoa (PB) and professor at the UFCG (Federal University of Campina Grande) medicine course, explains that monkeypox is not considered an STI (sexually transmitted infection). ). That’s because there is, so far, no conclusive research on whether the virus is transmitted through genital fluids or anal contact per se.
On the other hand, sex is an activity that exposes people to the disease, as contact with infected skin is the main mode of transmission. “The sexual act involves friction, which generates microtraumas in the skin that favor the transmission of contact diseases, as in the case of smallpox in monkeys”, says Batista.
For Bernardo Wittlin, an infectious disease specialist and preceptor in infectology at the University Hospital of UFMA (Federal University of Maranhão), this is a delicate discussion.
What we do know is that the virus exists in the genital fluids, but it has not yet been proven that the virus is active. The problem is that when classifying a disease as an STI, we can give the mistaken idea that this is the only route of transmission of smallpox from monkeys, which is not true. bernard Wittlininfectious disease doctor
The incubation period of the disease, which lasts from five to 10 days, includes initial symptoms such as fever, body ache, and swollen glands. Then, the pustules appear, the blisters on the skin that, over time, generate dry crusts. It is necessary to wait for the skin to fully regenerate before socializing again, which can take two to three weeks, on average. Wounds are highly infectious.
On the other hand, it is still a question for science whether the patient is already transmitting the virus at the initial moment of infection, in which there are still no pustules or scabs.
According to José Angelo Lindoso, an infectious disease specialist at the Instituto de Infectologia Emílio Ribas (SP) and professor at the USP School of Medicine (University of São Paulo), patients who have seen them report having had sex without a condom with partners who apparently did not have wounds.
Diagnosed patients say their partner had no skin lesions. People are getting infected with those who don’t have active lesions. There are also cases of people who have mild, discreet and few injuries, which creates a risk of transmission. José Angelo Lindoso, infectious disease specialist
Most patients have sores in the anal and genital region, but they can appear anywhere on the body.
According to Batista, there is ongoing research investigating whether the “rash” — the redness of the skin that precedes the blisters — is also a transmitter of the virus. This could explain sexual transmission between people without the pustules.
In other words, there is no exact form of protection — it would simply be not having sexual partners. But it is possible to take some precautions to reduce the risk of infection. See some below:
There is a scientific consensus when it comes to sexual health: using condoms is imperative. Experts report that condom use has declined, increasing sexual infections that weaken patients’ immunity, leaving them more susceptible to new diseases, such as monkeypox.
Although condoms do not fully protect against monkeypox — as it is a disease of contact with any infected skin — condom use remains important to reduce the risk of infection, in addition to protecting against various STIs.
Reduce the number of partners
At the end of July, WHO Director Tedros Adhanom declared that reducing the number of sexual partners is an important measure. “At the time, [é indicado] reduce the number of sexual partners, reconsider sex with new partners, and exchange contact details with new partners to allow follow-up if necessary,” he said.
The SBI (Brazilian Society of Infectious Diseases) and the SBU (Brazilian Society of Urology) issued a joint note giving the same recommendation, in addition to stating that “they are in solidarity with people affected by the disease and do not support any type of discrimination”.
The issue of discrimination refers to the majority of those diagnosed, who are men who have sex with men – which does not mean that other groups cannot be infected, such as women and children, who have also been diagnosed. The experts interviewed warned of the risk of stigmatization of the LGBTQIA+ population, which already suffers from marginalization, when it comes to the topic of monkeypox.
“Stigma has at least two negative consequences: it relaxes those who are not from that risk group and it keeps stigmatized people away from the health service, who fear being singled out, badly treated”, says Wittlin. If you suspect you have monkeypox, seek medical attention by covering the injured areas and wearing a mask.
Talk to partners about it
Although STIs are still taboo, talking about the topic with partners is important. In the case of monkeypox, it is no different, and conversation is also essential. If you have any symptoms or redness in any part of the body, let the partners know, cancel the dates and seek medical attention. According to experts, the more you talk about health issues, the better the protection against disease can be.
Getting regular STI screenings and encouraging partners to do the same is a positive attitude that can help raise general health awareness, as well as helping to demystify monkeypox.
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