Males who had intercourse with other men were the most likely to get infected with the monkeypox virus during the epidemic that occurred this summer in the United States and dozens of other nations. The first such research of women and nonbinary persons who had caught the illness found that thousands more women were also affected, and that many more instances were probably missing. The study was the first of its kind.
According to the case series that was published on Thursday in the journal Lancet, sexual contact was the most frequent source of infection among transgender women, accounting for 89 percent of cases. This finding is similar to the findings that were found in males. However, only 61 percent of instances could be attributed to sexual interaction among cisgender women and nonbinary persons who were designated female at birth.
According to Dr. Chloe Orkin, a physician and researcher at Queen Mary University of London, over one quarter of the cisgender women who participated in the study may have been infected even if they did not have any sexual contact with an infected individual. It was hypothesised that the ladies had contracted the disease as a result of exposure to the virus at their places of employment or residences, or via other forms of close contact.
The takeaway from this, according to Dr. Orkin, is that information about this topic should be shared with all individuals. She continued by saying, “it’s vital to remember this is not the only group,” despite the fact that it is acceptable that the majority of public health messaging have been addressed at guys who have sex with other men.
The epidemic of monkeypox in the United States has slowed down after many months of rapidly increasing case counts. This is partially due to a vaccination campaign and changes in the behaviour of many persons who were previously considered to be at high risk. Since May, there have been little more than 29,000 instances reported in the United States, but in the last month, there have only been approximately a thousand cases that have been identified.
Despite this, scientists are only just starting to grasp when and how the illness spreads, as well as who is at risk for it, even as public awareness of the sickness wanes.
In the recently published research, Dr. Orkin and her colleagues discovered genetic material from the monkeypox virus in all 14 of the vaginal swabs that they analysed. This finding lends credence to the hypothesis that the virus may be spread by genital secretions. Research conducted on males came to the same conclusion, finding the virus in their seminal fluid.
However, public health officials have been hesitant to classify monkeypox as a sexually transmitted sickness since they argue that the virus may be transmitted via any kind of intimate, physical contact.
Some medical professionals are of the opinion that the fact that monkeypox can be passed on in other ways should not disqualify it from being considered a sexually transmitted disease. They argue that this is because other diseases, such as herpes and syphilis, can also be passed on through close contact that does not involve sexual activity.
The findings of the latest research lend credence to that conclusion. In contrast to male monkeypox patients who report having intercourse with other guys, just 7 percent of the patients who participated in the research reported having attended a Pride event or other comparable gatherings. In the course of the preceding month, the transgender women who participated in the research had an average of roughly 10 sexual partners, but the cisgender women only had one, and seven percent of the cisgender women said that they had not had any sexual partners in the previous month.
A significant number of the transgender women who participated in the research had other risk factors for monkeypox, such as undiagnosed and untreated HIV infection, homelessness, and injectable drug use. More than half of the transgender women in the research participated in commercial sex work, while only 3 percent of the cisgender women did so. The percentage of transgender women who had the human immunodeficiency virus (HIV) was higher than the percentage of cisgender women who did so.
In the research, the majority of the transgender women sought treatment at sexual health clinics, while the cisgender women went to primary care providers or emergency rooms, where the attending physicians were more likely to be inexperienced with the symptoms associated with monkeypox. An estimated one in three women who identify as cisgender have been misdiagnosed or given a diagnosis for another illness; others were probably never diagnosed at all.
“It’s extremely conceivable that infections have been overlooked and not picked up at all,” said Dr. Orkin. “The likelihood of this happening is very high.”
The researchers found just two occurrences of monkeypox among the cisgender women who participated in the study, despite the fact that almost one in four of them lived with children. The findings made by the CDC are consistent with that result.
However, Dr. Karan expressed concern that instances of monkeypox in children may be underreported due to the negative connotations connected with the disease. According to him, further research is required to understand how symptoms may vary in various populations, especially in nations where the virus has caused outbreaks for years. Particularly relevant are countries where the virus has caused epidemics for years.