KINSHASA, Congo (AP) — As Congo copes with its biggest outbreak of monkeypox, scientists warn that discrimination against gay and bisexual men on the continent could make it worse.
In November, the World Health Organization reported that monkeypox, also known as mpox, was being spread via sex in Congo for the first time. That is a significant departure from previous flare-ups, where the virus mainly sickened people in contact with diseased animals.
Monkeypox has been in parts of central and west Africa for decades, but it was not until 2022 that it was documented to spread via sex; most of the 91,000 people infected in approximately 100 countries that year were gay or bisexual men.
In Africa, unwillingness to report symptoms could drive the outbreak underground, said Dimie Ogoina, an infectious diseases specialist at the Niger Delta University in Nigeria.
“It could be that because homosexuality is prohibited by law in most parts of Africa, many people do not come forward if they think they have been infected with mpox,” Ogoina said.
WHO officials said they identified the first sexually transmitted cases of the more severe type of monkeypox in Congo last spring, shortly after a resident of Belgium who “identified himself as a man who has sexual relations with other men” arrived in Kinshasa, the Congolese capital. The U.N. health agency said five other people who had sexual contact with the man later became infected with monkeypox.
“We have been underestimating the potential of sexual transmission of monkeypox in Africa for years,” said Ogoina, who with his colleagues, first reported in 2019 that monkeypox might be spreading via sex.
Gaps in monitoring make it a challenge to estimate how many monkeypox cases are linked to sex, he said. Still, most cases of monkeypox in Nigeria involve people with no known contact with animals, he noted.
In Congo, there have been about 13,350 suspected cases of monkeypox, including 607 deaths through the end of November with only about 10% of cases confirmed by laboratories. But how many infections were spread through sex isn’t clear. WHO said about 70% of cases are in children under 15.
During a recent trip to Congo to assess the outbreak, WHO officials found there was “no awareness” among health workers that monkeypox could be spread sexually, resulting in missed cases.
WHO said health authorities had confirmed sexual transmission of monkeypox “between male partners and simultaneously through heterosexual transmission” in different parts of the country.
Monkeypox typically causes symptoms including a fever, skin rash, lesions and muscle soreness for up to one month. It is spread via close contact and most people recover without needing medical treatment.
During the 2022 major international outbreak, mass vaccination programs were undertaken in some countries, including Canada, Britain and the U.S., and targeted those at highest risk — gay and bisexual men. But experts say that’s not likely to work in Africa for several reasons,
