Monkeypox data reveals disproportionate toll on LGBTQ community

Monkeypox data reveals disproportionate toll on LGBTQ community

As monkeypox cases quickly spread across California, the virus is inflicting an uneven toll on gay and bisexual men, according to new data released Friday by the state Department of Public Health.

The numbers show that among cases with available data, 91.7% of all patients who’ve tested positive for monkeypox have been gay people and 5.6% have been bisexual; men account for more than 98% of all cases. Transgender and gender nonbinary people account for 1% of cases.

While it’s been known for weeks that the virus was rapidly spreading through LGBTQ social networks, the state had not previously released such infection data.

LGBTQ advocates say releasing the data will help bolster their demands for a more urgent federal and state response. Showing the severity of the outbreak in the gay and trans community could also inform how the state distributes vaccines and shapes public-education campaigns and other relief efforts.

“It is so important to know who is getting sick and what groups are being disproportionately impacted because that will help guide the public health response,” said state Sen. Scott Wiener, D-San Francisco. “Without that data, we’re flying blind in terms of a public-health response.”

The data California includes is demographic information about sexual orientation for about 70% of the 786 patients who’ve tested positive statewide. There isn’t such data for the other patients who’ve tested positive.

It also shows how the virus has had a disproportionate impact, along both racial and generational lines.

Hispanic or Latino people account for nearly 36% of infections, although they are less than 19% of the population, according to available data on race and ethnicity. That means Latino people are nearly three times more likely than white people to contract the virus, relative to their share of the state’s population, with 3.2 cases per 100,000 residents, compared with 1.2 cases for white people.

Nearly 75% of infections occurred among people between the ages of 25 and 44. Health officials say that the infection is spreading most rapidly among people with multiple recent sexual partners.

The numbers show Los Angeles has seen the most cases, at 261, and San Francisco is close behind with 257.

State officials released the data a day after San Francisco declared a public health state of emergency in response to the growing spread of the virus. The city has seen at least 281 people with monkeypox infections, though there are likely far more cases that have gone unrecognized due to a lack of readily available testing and a lack of awareness among many health providers about the virus.

The crisis has been exacerbated by a shortage of available vaccines. So far, city officials say they have received about 8,200 doses of the Jynneos vaccine, which is intended to prevent monkeypox and smallpox in adults. City officials estimate they need as many as 70,000 doses.

Friday’s release of monkeypox data is significant for the LGBTQ community because it is the first time that the state has publicly released such data in response to the early stages of a public-health crisis.

In 2020, state legislators passed a law that requires the state to ask patients who are tested for possible exposure to infectious diseases about their sexual orientation and gender identity. California already collects data on race, age and gender for patients tested for the more than 90 communicable diseases it tracks. Patients can decline to answer the question.

Wiener proposed the measure, SB932, in response to the state not tracking the toll of COVID-19 on the community. He said it was intended to end decades of LGBTQ people being ignored in government’s response to health crises.

California has been gathering information about LGBTQ people infected with monkeypox for weeks, but state officials had previously declined to release the data. The Department of Public Health told The Chronicle earlier this week that it had not released it “due to patient privacy concerns.” There has also been a debate within the LGBTQ community about whether such data stigmatizes people.

Monkeypox in the Bay Area


On Friday, Department of Public Health chief Tomás Aragón said his team is committed to fighting stigma against the LGBTQ community, “which has been singled out and treated unfairly.”

“No single individual or community is to blame for the spread of any virus,” he told reporters during a conference call. “Monkeypox can affect anyone and it spreads by skin-to-skin contact, as well as from sharing items like clothing, bedding and towels.”

Wiener, who is gay, said he strongly disagrees with any argument that releasing demographic data about the communities affected by monkeypox infections is harmful.

“That’s just ridiculous and it feeds into the whole notion that being gay is this dirty private thing that we shouldn’t talk about in public,” he said. “We want the information. We want to know what’s happening in our community.”

Gay and transgender advocates have widely blasted what they consider a sluggish federal and state response to monkeypox. Many have equated the situation to the early days of the AIDS pandemic, when gay and bisexual men died by the tens of thousands as the government largely ignored the spread of the virus.

LGBTQ leaders have demanded the state and federal government declare a public health emergency in response to monkeypox, a move that would allow access to funds to fight the virus and increase public awareness.

While California doesn’t plan to declare a statewide health emergency, Aragón said Friday that the state “will continue to review everything” as the virus spreads. He said systems from the state’s COVID efforts have made it easier to respond to monkeypox and do things like create a vaccine registry.

“We’re looking carefully to see whether we need to do an official declaration of emergency, to see what additional authority or resources that may mobilize,” Aragón said. “We’re in a much better situation to be able to deal with monkeypox than if this had occurred two years ago.”

Wiener and other Democratic state legislators are negotiating a budget bill to increase state spending on testing, vaccination and contact tracing. They have also asked for federal authorization to spend some COVID-related funds on monkeypox response.

San Francisco’s state of emergency, declared by Mayor London Breed, takes effect on Monday. Breed said the move “will allow us to continue to support our most at-risk, while also better preparing for what’s to come.”

Monkeypox usually causes flu-like symptoms, along with a rash and dense, fluid-filled lesions. The virus is spread by intimate personal contact, including sexual acts and kissing. It can also be spread by sharing bedding or clothes, or potentially, breathing in close proximity.

Although many cases resolve on their own, monkeypox can be quite painful and, in rare instances, can cause severe illness.

Dustin Gardiner and Yoohyun Jung are San Francisco Chronicle staff writers. Email: dustin.gardiner@sfchronicle.com, yoohyun.jung@sfchronicle.com Twitter: @dustingardiner, @@yoohyun_jung

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