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Monkeypox being spread through sex, not brief skin-to-skin contact: experts

Health experts weigh declaring virus an STD

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Health experts are now emphasizing monkeypox is being spread through sex, not brief skin-to-skin contact.

Amid fears monkeypox would spread at an increased rate at the end of summer as gay men gather in close quarters for dance parties and other celebrations, health experts are starting to emphasize that the current outbreak isn’t spreading through minimal skin-to-skin contact, such as brushing up against a fellow shirtless dance partner, but rather through sexual activity and overwhelmingly among men who have sex with men.

With reported cases of monkeypox in the United States this week reaching 15,505, according to data from the Centers for Disease Control, a number of health experts who spoke to the Blade talked about outright declaring monkeypox a sexually transmitted disease as part of this messaging — although they acknowledge such a label would have pros and cons.

Juan Carlos Loubriel, senior director of community health at the D.C.-based Whitman-Walker Health, was among the health experts making the distinction between the negligible risks of transmitting monkeypox through brief skin-to-skin contact as opposed to sexual activity.

“I’ll say that we need to provide the real facts to our community that indicates right now that the majority of the cases are sexually transmitted, right?” Loubriel said. “So transmission is not occurring by casual touch, right? That’s what we know as of today … So the majority of the cases [are] by prolonged skin-to-skin contact, and during sex there is a lot of skin-to-skin contact.”

As health experts at large are beginning to make a distinction in how the disease is transmitted, the Biden administration has also taken up messaging that downplays the risk of monkeypox transmission through minimal skin-to-skin contact.

Demetre Daskalakis, who is the face of the LGBTQ outreach for the Biden administration as deputy coordinator of the White House monkeypox task force, made colorful remarks Friday during a conference call with reporters downplaying the risk of contracting monkeypox through brief contact, quoting a senior policy adviser at the CDC who has studied LGBTQ health issues.

“I think I’m going to quote my friend Robbie Goldstein that sex involves friction, and friction seems to be how this happens,” Daskalakis said. “So, I think, that from the perspective of events, the real risk at an event is low. Of course, you have to gauge that risk based on what you’re doing, so if there’s a lot of clothes out dancing and friction, that could be a mechanism of transmission, but just brushing by someone, I’ve said this many times before, just brushing by someone is probably low or no risk.”

Asked by the Blade during the call about any consideration on declaring monkeypox a sexually transmitted disease, Daskalakis said it’s “really important that the decision around monkeypox and whether it’s designated happen thoughtfully from the perspective of other implications.”

“What’s really important from the perspective of our communication on the ground is that our harm reduction and safer sex guidance really does mention the importance of sexual transmission or the associated transmission of the virus, and also provides guidance necessary, like reminding people that condoms may have a role — not necessarily the full role — in preventing monkeypox, but also reminds folks that skin-to-skin contact in the context of sex can be really a part of how transmission occurs,” he said.

The messaging is consistent with new studies finding cases of monkeypox are overwhelmingly the result of sexual activity. According to a recent report by NBC News, an increasing amount of scientific evidence — such three studies published in peer-reviewed journals, as well as reports from national, regional, and global health authorities — has indicated “experts may have framed monkeypox’s typical transmission route precisely backward.”

“[A]n expanding cadre of experts has come to believe that sex between men itself — both anal as well as oral intercourse — is likely the main driver of global monkeypox transmission,” the NBC News report says. “The skin contact that comes with sex, these experts say, is probably much less of a risk factor.”

With evidence the monkeypox outbreak is overwhelmingly being transmitted through sexual activity and risks from skin-to-skin contact virtually non-existent, experts say discussion on whether or not to label the virus as a sexually transmitted disease are ongoing and controversial.

On one hand, designating monkeypox as a sexually transmitted disease would give the public a clearer idea about the way it’s being transmitted to allay concerns and enable the public to take appropriate precautions. On the other hand, as seen during the height of HIV/AIDS crisis, an emphasis on monkeypox being transmitted among men who have sex with men may have the effect of stigmatizing the community (and the sexual activity) as being responsible for the outbreak.

Loubriel said the issue of whether or not monkeypox should be messaged more as a sexually transmitted disease is “a very good question and also a very big debate around public health, even within the public health sector.”

“The only reason we cannot say it is just sexually transmitted is because we know as a fact that it can be spread by other various avenues like touching clothing, bedding with an infected person or towels being used by someone with monkeypox, potentially contact with respiratory secretions,” Loubriel added. “So that is why it’s probably not been named as a sexually transmitted infection.”

Joseph Lee, a professor of health education at East Carolina University who studies health inequities among LGBTQ people, said there’s “real tension” in finding the right messaging, which he said would strike a balance between being factual while not being stigmatic of the marginalized community affected by monkeypox.

“We see when we have messaging that goes to the general public…that messaging about how a particular group is doing worse triggers negative stereotypes and makes people feel less at risk than they are,” Lee said. “And really importantly, it makes the group at the worst end of that problem feel sometimes like they’re feeling fatalistic or they can’t do anything to protect themselves. You almost feel like you have to give up and you’re just going to get it anyway because the messaging is so clear, how much it’s impacting your community.”

Lee, however, praised communications on monkeypox from the Centers for Disease Control & Prevention, saying the agency has “very useful guidance about promoting equity in monkeypox communication that I actually really like.”

Key points in the guidance, Lee said, is messaging that monkeypox can affect anyone, while going through some of the ways the virus is being transmitted and ways the public can protect itself. The guidance, Lee said, follows the right strategy of articulating a message to the general public, then adding more specific messages about protection against the disease and risk to the communities most vulnerable.

“That’s sort of their big picture strategy that I think is actually the right strategy,” Lee concluded. “How well everyone’s implementing it across the country in our messy, somewhat broken public health system is another question.”

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The White House

Trump will refuse to sign voting bill without anti-trans provisions

Measure described as ‘Jim Crow 2.0’

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President Donald Trump speaks at the State of the Union address at the U.S. Capitol on Feb. 24, 2026. (Washington Blade photo by Michael Key)

President Donald Trump said he will refuse to sign any legislation into law unless Congress passes the “SAVE Act,” pressuring lawmakers to move forward with the controversial voting bill.

In posts on Truth Social and other social media platforms, the 47th president emphasized the importance of Republican lawmakers pushing the legislation through while also using the opportunity to denounce gender-affirming care.

“I, as President, will not sign other Bills until this is passed, AND NOT THE WATERED DOWN VERSION — GO FOR THE GOLD,” Trump posted. “MUST SHOW VOTER I.D. & PROOF OF CITIZENSHIP: NO MAIL-IN BALLOTS EXCEPT FOR MILITARY — ILLNESS, DISABILITY, TRAVEL: NO MEN IN WOMEN’S SPORTS: NO TRANSGENDER MUTILIZATION FOR CHILDREN! DO NOT FAIL!!!”

The proposed Safeguard American Voter Eligibility (SAVE) Act would amend the National Voter Registration Act of 1993 to require in-person proof of citizenship for anyone seeking to vote in U.S. elections. Trump has also called for the legislation to include a ban on gender-affirming medical care for transgender minors, even with parental consent.

“This is a huge priority for the president. He added on some priorities to the SAVE America Act in recent days, namely, no transgender transition surgeries for minors. We are not gonna tolerate the mutilation of young children in this country. No men in women’s sports,” White House Press Secretary Karoline Leavitt said. “The president putting all of these priorities together speaks to how common sense they are.”

The comments mark the first time the White House has publicly confirmed that Trump is pushing to attach anti-trans policies to the SAVE Act.

The bill would also require the removal of undocumented immigrants from existing voter rolls and allow election officials who fail to enforce the proof-of-citizenship requirement to be sued.

It is already illegal for noncitizens to vote in federal elections. Current safeguards include requirements such as providing a Social Security number when registering to vote, cross-checking voter rolls with federal data and, in some states, requiring identification at the polls.

Trump began pushing for the legislation during his State of the Union address last month, where he singled out Senate Majority Leader John Thune (R-S.D.) by name while criticizing the lack of movement on the bill.

Senate Minority Leader Chuck Schumer (D-N.Y.) has denounced the legislation as “Jim Crow 2.0” and said it has little chance of advancing through the Senate, calling it “dead on arrival.”

In remarks on the Senate floor, Schumer said “the SAVE Act includes such extreme voter registration requirements that, if enacted, could disenfranchise 21 million American citizens.”

Trump has repeatedly used political messaging around trans youth and gender-affirming care as part of broader cultural and policy debates during his presidency — most recently during his State of the Union address, where he cited the case of Sage Blair, a Virginia teenager whose school allegedly encouraged her to transition without her parents’ consent.

LGBTQ advocates — including those familiar with Blair’s story — say the situation was far more complex than described and argue that using a single anecdote to justify sweeping federal restrictions could place trans people, particularly youth, at greater risk.

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Health

Too afraid to leave home: ICE’s toll on Latino HIV care

Heightened immigration enforcement in Minneapolis is disrupting treatment

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(Photo by Liam James Doyle for Uncloseted Media and Rewire News Group.)

Uncloseted Media published this article on March 3.

This story was produced in collaboration with Rewire News Group, a nonprofit publication reporting on reproductive and sexual health, rights and justice.

This story was produced with the support of MISTR, a telehealth platform offering free online access to PrEP, DoxyPEP, STI testing, Hepatitis C testing and treatment and long-term HIV care across the U.S. MISTR did not have any editorial input into the content of this story.

By SAM DONNDELINGER and CAMERON OAKES | For two weeks, Albé Sanchez didn’t leave their house in South Minneapolis.

“[I was] forced into survival mode,” Sanchez told Uncloseted Media and Rewire News Group (RNG). “I felt like there was an invisible wall [to the outside world] that I couldn’t cross unless I really wanted to put myself in a place where there was a chance that I might not be able to come back.”

Queer and Mexican American, Sanchez was afraid of being targeted by the Immigration and Customs Enforcement presence in their neighborhood, even though they are a U.S. citizen.

“Every day is a risk,” they say, adding that even if they have paperwork, if they fit the profile, they are a target, making it scary to go even to work or the grocery store.

Sanchez, a 30-year-old sexual health care educator, has been taking oral PrEP, the daily preventive medication for HIV, for over a decade. But the mounting stress of ICE raids has made it harder to keep up with dosing.

“A missed dose here and there pushed me to make the appointment [for something more sustainable],” they say.

Sanchez says they felt like somebody would have their back at their local clinic. It was only a 10-minute drive from where they worked, they knew its staff from previous visits and community outreach, and they could count on finding Spanish-speaking staff and providers of Latino heritage. But not everybody has had that same experience accessing care.

Since ICE’s Operation Metro Surge began in early December, an increasing number of Latino patients in Minnesota are delaying or canceling what can be lifesaving care for the prevention and treatment of HIV.

These findings are particularly alarming for Latino communities, who, as of 2023, are 72 percent more likely than the general U.S. population to be diagnosed with HIV. And while overall infections have decreased, cases among Latinos increased by 24 percent between 2010 and 2022.

“I’m very concerned that there is going to be a sharp uptick in transmission,” says Alex Palacios, a community health specialist in the Minneapolis area.

In a January 2026 declaration as part of a lawsuit seeking to end Operation Metro Surge in the days following Renee Nicole Good’s killing, the commissioner of the Minnesota Department of Health said HIV testing among Latino populations has “dropped dramatically” and that “although grantee staff continue to go into the community to promote and provide testing, people are not showing up.”

Local clinics are reporting the same thing. The Aliveness Project, a community wellness center in Minneapolis specializing in HIV care, told Uncloseted Media and RNG they have seen more than a 50 percent decrease in new clients. The clinic serves a large number of Latino and undocumented clients, and while it usually sees 750 people walk through their door each week, according to providers, it reported seeing 100 fewer people each week since December.

Red Door, Minnesota’s largest STI and HIV clinic, has had a “modest uptick” in no-shows and missed appointments since December.

What happens when treatment stops

Today, there are multiple medications available that work to prevent HIV and dozens that treat it once a person tests positive. Many people who consistently take their medication have such low levels of the virus that they can’t transmit it through sex. But becoming undetectable requires patients to stay on their medication; otherwise, the virus replicates and mutates, weakening the immune system and increasing the risk of life-threatening infections.

“If patients aren’t on their medicines consistently, HIV can learn about the medication and become resistant to them. When this happens, the medicine will not work for the patient, and the new resistant virus could potentially be passed on to others,” says George Froehle, a physician assistant and provider at Aliveness Project. “Medication adherence is one of the most important aspects of HIV care.”

To maintain care and prevent dangerous, untreatable strains from spreading in Minnesota, providers at Aliveness Project have begun delivering medication to patients when possible, offering telehealth when they can, and pausing routine lab work to limit in-person appointments.

“The most important thing we can do from a public health perspective is to keep people undetectable so they don’t transmit HIV,” Froehle says, adding that providers in other cities targeted by ICE will need to make plans for missed injection visits, pivot to telehealth and prepare their teams for the “trauma that can occur.”

Sanchez understands the risks of inconsistent treatment, which is why they opted for the injectable preventative medication.

“I have a lot of risk [to HIV in my community],” Sanchez says. “With so much uncertainty about the future and whether HIV care will remain stable, I realized I couldn’t let this opportunity pass.”

But injectable HIV treatments are commonly dosed at two weeks to six months apart, and the medication must be administered in a clinic — a setting many patients are avoiding, according to providers.

“They have a two-week window” to get their shots, according to Froehle, who added that because patients are afraid to come in person, they have had to transition people off of their injectable HIV treatments. This has caused patients to return to oral HIV treatments without the testing they would normally receive had ICE not been in Minneapolis. “[Oral treatments] weren’t super successful [for these patients] to begin with and that’s why they were on injectables.”

Oral HIV medications, too, must be taken consistently to work. In response, providers have urged patients to have their pills with them at all times in case they get deported or detained.

The caution is not unfounded. Federal immigration facilities have a history of denying adequate medical care to people living with HIV, despite internal standards that require them to comply. Since 2025, at least two men living with HIV have been denied access to their medication in a Brooklyn jail, according to lawsuits obtained by THE CITY. One man said he was only given his medication after his lips broke open and he developed an open pustule on his leg. And in January 2025, another man died of HIV complications while in ICE custody in Arizona.

Beyond being detained without proper medication, patients are at risk of being deported to countries with limited access to HIV care, like Honduras and Venezuela, experts say.

“A lot of men [from Venezuela] told me they left because it wasn’t safe to be gay there and because they struggled to access HIV care,” says Froehle. “It’s a little heartbreaking to see new folks not only face the threat of deportation, but to places where they didn’t feel safe medically or identity-wise.”

“Some of these patients will die in their home country,” says Anna Person, the chair of the HIV Medicine Association. “It’s a death sentence.”

A ‘cascading disaster’

While ICE’s presence is threatening the infrastructure of HIV care that Minneapolis has built over decades, experts say there has always been a blind spot in HIV care for the city’s Latino community.

Vincent Guilamo-Ramos, executive director of the Institute for Policy Solutions at the Johns Hopkins University of Nursing, describes HIV in Latino communities as a “cascading disaster,” the result of years of compounding inequities.

“There’s been an invisible crisis among Latinos that hasn’t gotten traction,” he says. “The numbers have consistently gone up in terms of new infections, while nationally they’ve gone down. … That should be a big alarm.”

Numbers are rising because structural barriers and stigma are preventing Latinos from receiving care. A 2022 report from the Centers for Disease Control and Prevention found that between 2018 and 2020, nearly 1 in 4 Hispanic people living with HIV reported experiencing discrimination in health care settings. Lack of representation among providers, language barriers and deep-rooted medical mistrust further complicate access to care, according to Guilamo-Ramos.

Beyond the medical system, stigma within Latino communities can be equally damaging. According to Human Rights Campaign data, more than 78 percent of Latino LGBTQ youth reported experiencing homophobia or transphobia within the Latino community in 2024.

Sanchez agrees that stigma and bias are already massive barriers to care, citing the strict gender norms and Catholic beliefs many Latino communities hold. They say ICE’s presence is threatening already delicate access to HIV care.

“This has caused so much damage to people,” Sanchez says. “Not being able to access your health care appointments is such a stab in the side. … Being able to navigate any of these things in normal circumstances already has so much difficulty to it.”

Palacios, who is Afro-Latine and living with HIV, says the heightened ICE presence is worsening barriers that have long undermined the Latino community’s access to HIV care.

“The horizon has always been stark and dim,” they say. “And this just feels like one more thing to address and to fight back against.”

Sliding backwards

Navigating HIV care is becoming more difficult across the board, as the federal government has decimated HIV funding, compromising decades of progress made in the fight against the virus since Donald Trump retook office just over a year ago.

In February 2026, three months into Operation Metro Surge, the Trump-Vance administration proposed slashing $600 million in HIV-related grants, targeting four blue states, including $42 million for Minnesota programs. A federal judge has temporarily blocked the cuts.

“This would completely decimate and gut all of our HIV prevention,” says Dylan Boyer, director of development at Aliveness Project. “That’s the reality that we live in.”

“We have all the tools, and yet we are staring down this rollback of infrastructure and research dollars, prevention efforts, treatment efforts, that are going to put us squarely back in the 1980s,” says Person, a national HIV expert who grew up in Minnesota. “[There] seems to be no other rationale for that besides cruelty, to be quite frank, since there’s no scientific reason for it.”

Repair and representation

Jenny Harding, director of advancement at a Minneapolis-area supportive housing program for people living with HIV, says that while ICE’s presence is lessening in the Twin Cities, the “damage is done.”

Person says that this mending will take time, especially between the medical community and patients, since HIV providers can have a “very fragile” relationship with their clients.

“It takes, sometimes, years to build that level of trust. And I do worry that folks are just going to say, ‘I don’t feel safe here anymore. The system does not have my best interest at heart, and I’m not coming back,’” she says. “This is not something that you can flip a switch and everything will go back to normal.”

“We need to hold our federal government accountable, particularly HHS, [and] we need to ensure that HIV funding remains intact,” Guilamo-Ramos says, adding that in order to lower rates of HIV in the Latino community, there should be more specialized efforts: such as bilingual and culturally aligned health care providers, community-based outreach programs co-located where risk is highest, trust-building initiatives to address medical mistrust, mobile clinics, and targeted programs to re-engage patients who have fallen out of care.

Aliveness Project’s patient numbers have increased in the last few weeks as the ICE operation has waned, but the clinic staff is keeping “a watchful eye” and is having “difficulty reaching folks who are understandably scared.”

“Our biggest focus right now is reconnecting with people through our outreach so no one has a lapse in their HIV medications or prevention care,” Boyer, of Aliveness Project, says.

For Sanchez, seeing providers who speak Spanish and are of Latin heritage at Aliveness Project built enough trust for them to reach out and make an appointment despite the risks. Sanchez feels optimistic about their new injectable prevention strategy with the support of their clinic.

“There’s many places where you can receive care here in the Twin Cities where you might not see your skin tone. … There’s still a lot of health care professionals that unfortunately carry bias. … Aliveness is the opposite of that,” they say. “Seeing that representation and knowing someone has that cultural context of how to meet you in moments of sensitivity, it’s crucial.”

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Florida

Fla. Senate passes ‘Anti-Diversity’ bill that could repeal local LGBTQ protections

Bipartisan coalition urges Florida House to reject ‘extremism’ measure

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The Florida Capitol (Washington Blade photo by Yariel Valdés González)

The Florida Senate on March 4 voted 25-11 to approve an “Anti-Diversity in Local Government” bill that critics have called a sweeping and extreme measure that, among other things, could repeal local LGBTQ rights protections.

According to Equality Florida, a statewide LGBTQ advocacy organization, if approved by the Florida House of Representatives and signed by Republican Gov. Ron DeSantis, the bill “would ban, repeal, and defund any local government programming, policy, or activity that provides ‘preferential treatment or special benefits’ or is designed or implemented’ with respect to race, color, sex, ethnicity, sexual orientation, or gender identity.”

In a March 4 statement, Equality Florda added that the bill would also threaten city and county officials with removal from office “for activities vaguely labeled as DEI,” with only limited exceptions.

The Florida House was scheduled to vote on the bill on Monday, March 9, with opponents hopeful that a broad coalition of both Democratic and Republican lawmakers would secure enough votes to defeat the bill.

“Once again, Gov. DeSantis and Florida lawmakers are advancing one of the most sweeping and extreme bills in the country — this time threatening decades of local progress supporting diverse communities, including the LGBTQ community,” said Equality Florida Senior Political Director Joe Saunders. “This legislation is a sledgehammer aimed at cities and counties that recognize and address the diversity of the people they serve,” he said.

Among the LGBTQ organizations that could be adversely impacted by the bill is the highly acclaimed Stonewall National Museum, Archives and Library located in Fort Lauderdale.

Robert Kesten, the Stonewall organization’s president and CEO, told the Washington Blade the organization receives some funding from Broward County, in which Fort Lauderdale is located, and the city of Fort Lauderdale has provided support by purchasing tables at some of the museum’s fundraising events.

“Based on this legislation, hose things would be gone,” he said. “We also are based in a government building. So, we don’t know what potential side effects that could have.” He noted that the building in question is owned by Broward County and leased by Fort Lauderdale, with the bill’s vaguely worded provision making it unclear whether Stonewall would be forced to leave its building.

“It’s unknown, and we’re really in unchartered waters,” he said.

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