International AIDS Conference | Parallels drawn with monkeypox

A session on monkeypox added at the last minute to the International AIDS Conference at the Palais des Congrès has drawn heated parallels with the AIDS pandemic. Here too, treatment in Africa and stigma are making headlines.

Mathieu Perreault
The Press

Demonstration

About 20 protesters interrupted the session on monkeypox in the middle, just before a speaker from the US government, Demetre Daskalakis, took the floor. Two dissatisfactions dominated: the insufficient number of vaccines in the United States and the absence of vaccines and diagnostic tests in Africa. “It’s been decades since monkey pox hit black bodies in Africa without anyone doing anything,” denounced during the demonstration an American activist of Haitian origin. “Now that white bodies are affected, finally something is being done. »

A new symptom

A new symptom, on the anus and associated with constipation, was discussed during the session. A UK National Health Service (NHS) specialist, Nicolo Girometti, has reported that one in five patients have this new symptom, which has not been linked to monkeypox until now. Worryingly, 17% of patients have no symptoms prior to the lesions, such as fever or sore throat, and two-thirds have skin lesions at the same time as these first symptoms of the disease. On the plus side, the D^r Girometti reports that less than 10% of patients need to be hospitalized and only a quarter need to take antibiotics. Only 1% of patients in the UK are not men who have sex with men, a third have tested HIV and another third have an active sexually transmitted infection (STI). On average, the patients had had five different sexual partners during the three months preceding the diagnosis.

STI or not?

The possibility that the current monkeypox pandemic has an STI component was discussed during the session. Until now, public health authorities have been careful to point out that monkeypox is transmitted by contact, not just sexual contact. A Mexican doctor asked during the question period “if it was an STI”, but the speakers preferred to avoid this question, answering another question from the Mexican doctor instead. The D^r Girometti, from the NHS, said lesions are present in the “genito-anal region” in 93% of patients, in the arms and legs in 40% of patients and in the face in 25% of them. These figures “suggest” that there could be a sexual inoculation, said the D^r Girometti.

Communication

The D^r Daskalakis, who has been chief HIV/AIDS prevention officer at the US Centers for Disease Control and Prevention (CDC) since last year, greeted the event before his presentation. Above all, he spoke of the importance of new communication channels to “help people at risk to reduce their risk”, in particular through campaigns broadcast on social networks by companies popular with the LGBTQ community, and a “new language” in CDC communications. He gave as an example a leaflet where masturbation is offered on their own to those who want to have sex with a person infected with monkeypox. During question period, a Philadelphia doctor said he was “appalled” at the insistence of Dr.^r Daskalakis on communication as he runs out of vaccines to treat his patients.

Decolonization

Earlier Monday morning, another comparison, between COVID-19 and AIDS, also ignited passions. “If the big boss of the WHO had been a white man rather than an Ethiopian, I’m sure Western governments would have taken COVID-19 seriously sooner,” said Ayoade Alakija, a Nigerian who serves as a special envoy for the World Health Organization (WHO) for the “acceleration of tools against COVID-19”. The D^D Alakija participated in the session on “decolonizing the AIDS response” from Nigeria as a show of solidarity with Africans who did not have visas to attend the Conference. “If you don’t want to host us, we should do the Conference only in the countries of the Global South. »