PHOENIX – LGBTQ activists in Arizona are stepping up efforts to fight stigma and intolerance amid the global outbreak of monkeypox – even as they work to get more people vaccinated against the viral disease, which is contracted through close or intimate contact.

Some conservatives, including state Sen. Wendy Rogers, R-Flagstaff, have posted anti-LGBTQ messages on social media in connection with the disease. And in Washington, D.C., two men filed a police report in August saying they were punched by assailants who used an anti-gay slur and referenced monkeypox.

“We are still trying to overcome the stigma of the HIV and AIDS era, so to have a new illness start to emerge more prevalently that has taken root to some extent in the gay male community … it triggers concerns,” said Jeremy Helfgot, a spokesperson for Phoenix Pride. “The concern is that we may see that kind of stigma return.”

Monkeypox, which is rarely fatal, is among the family of viruses that includes smallpox. Symptoms include lesions that may look like pimples or blisters, along with possible fever, chills and muscle aches.

“The richest source of virus can be found in the lesions of monkeypox,” said Grant McFadden, director of the Biodesign Center for Immunotherapy, Vaccines and Virotherapy at Arizona State University. “Any physical contact – whether sexual, through clothing or bedding – has the potential to transmit the virus.”

Monkeypox was discovered in 1958 in laboratory monkeys in Denmark. Although the source of the disease remains unknown, it has been linked to rodents. The first human cases were reported in 1970 in Africa, and until recently, the disease was found almost exclusively in Central and West Africa, McFadden said.

The latest outbreak arose in May when cases were identified in Europe and the U.S. So far this year, about 67,000 cases have been reported globally. That includes 25,000 in the U.S., with about 470 of those in Arizona, according to the Centers for Disease Control and Prevention.

People of color – especially Black and Hispanic people – have been disproportionately affected, CDC statistics show.

Given that COVID-19 also has disproportionately affected people of color, some worry those most in need of care aren’t getting the help they need.

“The white gay community has a lot of resources – they have nonprofit organizations, they have clinics and private doctors that are culturally atuned to our queer community,” said Richard Zaldivar, an LGBTQ advocate in Los Angeles. “But when you look at people of color communities, we do not have that capacity.”

Broadly, LGBTQ individuals face more barriers to health care, research shows. A February study by researchers at UCLA found lesbian and bisexual women and gay men are more likely than straight men and women to experience bias when getting medical care.

Helfgot worries that, like HIV and AIDS, monkeypox is perceived by the public as a so-called gay disease because most cases in the current outbreak have occurred among men who report sexual or close intimate contact with other men.

“Ignorance itself is almost its own kind of opportunistic infection, and it will take hold of anyone who’s willing to embrace it,” he said. “It is clear there are subsets of the U.S. population that, for lack of a better word, hate the LGBTQ+ community. So when there’s a new opportunity to say, ‘Hey, look, we can blame this particular community,’ they are going to jump on it.”

He and others recalled the early days of the AIDS epidemic in the 1980s, when a lack of support and knowledge at times led to hysteria. Some Americans wanted to force those with AIDS to quarantine or carry around an ID card.

Zaldivar was a young activist during that time, working to educate Latinos in the Los Angeles area about HIV/AIDS. He later founded The Wall Las Memorias project to build a monument in LA’s Lincoln Park to those lost to AIDS.

“I decided I wanted to give back, because I understood the cultural constraints that we had in dealing with HIV and AIDS and sexuality,” Zaldivar said. “It was a different period of time.

“I think we see the stigma attached to monkeypox, (but) not as great as HIV because I think the community, the powers that be, the media have been a little bit more understanding of stigma and queer community.

“It’s a health issue,” he said. “And it impacts everybody and anybody.”

In Phoenix, the Southwest Center for HIV/AIDS held a virtual town hall recently to talk about stigma, how to identify symptoms and when and where to get vaccinated. The group encouraged anyone facing backlash to seek therapy and support and to speak out.

The CDC issued a guide to help reduce stigma around monkeypox. Suggestions include stressing that monkeypox can be acquired regardless of sexual orientation or gender identity.

Health experts note that anyone could contract the virus through skin-to-skin contact with body fluids or sores. It’s also possible to be infected via respiratory droplets.

The CDC recommends vaccinations primarily for those who are in close contact with someone who has monkeypox and for those whose sex partners have been diagnosed recently. However, the nation is facing a shortage of available doses.

In Maricopa County, home to the vast majority of Arizona’s monkeypox cases, vaccines are being prioritized for those considered high risk. The Southwest Center and other sexual health clinics are leading the charge on vaccine distribution.

This Saturday, the center is partnering with Phoenix Pride to hold a free vaccination clinic as part of the Pride in Your Health campaign leading up to the 41st Phoenix Pride Festival and Parade in mid-October.

Casey Simon, director of health care operations at the Southwest Center, has seen both men and women coming in to get vaccinated – which gives him hope that education is working.

“Whether you are a (cisgender) heterosexual female or you identify as queer, it’s skin-to-skin. We all have skin, so let’s protect everybody and get vaccinated when you can,” he said. “It’s an everybody problem. … I don’t want us to stop talking about it.”