Monkeypox is infecting Hyde Parkers and disrupting gay and bisexual Hyde Parkers’ social lives amid anxiety about the disease and wait times for vaccines’ immunity.
The overwhelming spread of the virus that comes through the disease is currently occurring through sex between men, though it can spread through any intimate skin-to-skin contact (e.g., kissing) or close household contact like sharing towels, bedding, dishes or silverware.
Dr. John Schneider, the medical director of the LGBTQ-oriented Hyde Park Howard Brown Health clinic, 1525 E. 55th St., thinks the few children who have contracted the disease got it through household spread, as have half of the women who have gotten it. (The other half contracted it sexually or through close personal contact.)
Right now, the clinic is doing 15 to 20 monkeypox tests a day, around six of which turn out to be positive cases. Others are coming in presenting recent monkeypox infections that are clearing up.
Many more people are coming in over-concerned with common conditions like hemorrhoids or ingrown hairs, a testament to how anxious people are about monkeypox, Schneider said; the clinic does not test them for the disease. Howard Brown's Hyde Park location has a walk-in sexually transmitted disease clinic. Lesions used to only be syphilis or herpes, but now with lesions also also being caused by monkeypox, the clinic is doing more testing for the former two diseases.
The number of people with monkeypox seeking care at the local clinic has increased over the past month, and Schneider said more people of color are showing up for care. He estimated that the previous 70-to-30 ratio of white-to-Black patients has reversed.
He said it is unclear if this is because South Side communities of color did not have enough information early on or because there is more spread within them, but he believes, from community engagements with Black LGBTQ South Siders who do not know much about monkeypox, that the former is true.
"I think a lot of the challenges that we're facing on the South Side, particularly with HIV and other things, has to do with these types of infections, including COVID and now monkeypox, going to the most vulnerable," Schneider said. "If I'm couch-surfing or out trying to find some food, I'm more susceptible to exchange sex or just being with an older guy, or being in the wrong place at the wrong time. I think a lot of it is the typical power imbalances that we have in our society."
Schneider's clinic has tested a few university students positive for monkeypox, but he said most of the people who have tested positive are from places like Lakeview East who have come down to get tested, or South Siders not from Hyde Park. But he noted that Howard Brown is getting a number of referrals from UChicago Medicine (where he is a professor of medicine and epidemiology) and that the university health care system treats a number of Hyde Parkers. (A UChicago Medicine spokeswoman confirmed that the institution is testing for and treating monkeypox.)
Schneider said any Chicagoan who has sex with men who comes into Howard Brown is eligible. (Appointments can be scheduled by calling 872-269-3600.) In accordance with Chicago Department of Public Health (CDPH) policy, the clinical network has shifted to only giving out first doses of the monkeypox vaccine, Jynneos, a two-dose vaccine that its manufacturers say should be given at least 28 days apart.
"The first dose is highly protective," Schneider said. "We're not doing the second dose because that just makes it durable over years, and right now we just need to get everyone susceptible with their first dose. They can get their second dose in a year or something, when the manufacturer comes up with more doses."
"People are worried, because they're still in 'COVID mentality.' Like, 'You need the second dose to boost your immunity.' All the data suggests that it really just makes the protective effect last for a longer period of time rather than increasing the protection within the first two months when first doses are given," Schneider said.
Nationwide, monkeypox cases are doubling around every week, with the Washington Post reporting that the nation only has one-third of the vaccines needed to immunize the nation's at least 1.6 million high-risk men who have sex with men and no more vaccine expected until October. A Food and Drug Administration spokesperson told the Post that the agency advised against giving out only one dose instead of two.
The outbreak is affecting many gay, bisexual and queer Hyde Park men, whether they have contracted the disease, are trying to get a vaccine or waiting for their vaccine appointment, or have already been vaccinated.
LGBTQ life in Hyde Park is logically affected by many of the characteristics that uniquely affect other components of life in the neighborhood. It is a nexus for middle and upper class LGBTQ people, notably Black LGBTQ people; corresponding with its racial and ethnic diversity are a higher-than-average number of interracial couples, gay and straight. As host of the University of Chicago, the transience of its young adult population affects the permanence of social life and networks. The South Side has a notable lack of LGBTQ-oriented businesses. Twelve miles from the hub of the city's LGBTQ nightlife in Lakeview East, many LGBTQ Hyde Parkers find themselves leaving the neighborhood for nights out to gay bars and clubs.
Geoffrey Rees, an instructional professor at the U. of C., has lived in Hyde Park for 18 years. He got vaccinated through Howard Brown, having called their vaccine appointment number, received a call back 36 hours later to schedule and got an appointment within the week.
"They've done an amazing job getting it out, although I know there's not enough and it's frustrating for people," he said. "But for me it's been great. … I probably was lucky that I called right when they were starting to give the vaccines without knowing it. Maybe there are worse wait times now, but at least my experience was great."
Rees is single, not going on dates because of the outbreak, and would like to feel comfortable dating and meeting people again.
"Of course I want to be able to meet people safely," he said. "I'm all for vaccines of any kind, so why not? And I'm also familiar with the other strategies for containment, the public health logic behind vaccination I get and support, and I'm glad to be a part of it."
"I can be frustrated for six weeks for the sake of my health and a lot of other people's health. That's OK," Rees said.
Konrat Pekkip got his first shot last week. Getting the appointment at Howard Brown's Englewood clinic, 641 W. 63rd St., was difficult because there was limited availability, but Pekkip, who is German and just finished his master's degree at the U. of C., wanted to get a shot before leaving the United States.
Germany, like the U.S., is a federal republic, where states are running their own monkeypox vaccination programs. Baden-Württemberg, the state where Pekkip moved, was just beginning its vaccine rollout at the end of July.
"Given the scarcity of the vaccine, I'm really glad that I was able to get an appointment," he said. "I need to act now. I need to get this vaccine now, because I am gay. … It's important to me to not get the disease."
Pekkip's sense of urgency about the outbreak has swelled in the past few weeks. He said queer nightlife, where people rub up against each other, feels less safe, as "you're bound to encounter people who may or may not have the disease." He plans to avoid those environments until he gets his second shot.
Carter Oselett is Pekkip's former roommate and works for the AIDS Foundation of Chicago (AFC), 200 W. Monroe St., a social service organization that has begun to work on monkeypox issues.
Oselett was in New York City in late-June for the city's Pride celebration when a sexual health clinic in Chelsea, a tiny, historically gay neighborhood in Manhattan, held a first-come, first-served monkeypox vaccination event that got swamped.
"Hundreds of people, and they ran out pretty instantly," Oselett said. "All of us were like, 'Is this something we should be worried about now, if we're going to be with thousands of gay men around us?' Seeing people get vaccinated, we thought, 'Well, maybe this is something we should think about.'"
Oselett wound up getting vaccinated at Howard Brown's pop-up the following weekend at the Pride South Side festival in Washington Park, where he had been tabling for AFC.
Like many gay Chicagoans, Oselett spent July following announcements of monkeypox vaccine pop-ups to get that information to unvaccinated friends.
"I'm frustrated with the city because of the lack of a coordinated response. I'm frustrated that we're really having to take it into our own hands," he said. "I think it is frustrating that we are posting on our Instagram Stories information about these appointments. Some of them aren't even accurate." (Last week, CDPH put information about clinical vaccine providers on the website chi.gov/monkeypox.)
Oselett also has experience in political and student activism from his time as an undergraduate at Michigan State University. He has started phoning into organizing calls; there has been some protest activity in New York but not Chicago.
"I'm trying to get people to protest and get in front a bit," Oselett said. "I've seen an appetite of people to get going; I just don't think there's as much existing infrastructure (in Chicago). It's a smaller city, and there's a lot of nonprofits around us. But it's not like we have an ACT UP (the New York-based anti-AIDS political group) or anything like that anymore at least."
He is concerned about equity, with vaccine pop-ups being held at the bathhouse in Lakeview East, where people can buy club memberships and skip the line for a shot. Others have waited in line for vaccines that have run out before their turn comes up.
He wants a broadening of CDPH eligibility guidelines, currently close contacts of someone who has monkeypox or men who have sex with men who are 18 or older and have had multiple or anonymous sex partners, sex at a social or sexual venue or sex in exchange for money or goods within the past 14 days. The guidelines dictate that the vaccine is not recommended for the general public, including men who have sex with men without the additional criteria.
And he called for the a federal health emergencies declared to free up additional resources to fight the outbreak. Gov. J.B. Pritzker did so on Monday, Aug. 1, enabling the Illinois Department of Public Health to utilize resources for coordinating logistics across state agencies, including the Illinois Emergency Management Agency, to distribute vaccines and prevent and treat the disease. In a statement, CDPH Commissioner Dr. Allison Arwady said Chicago does not need its own emergency declaration because the city is covered by the state's.
"I know they've also had some Facebook Live events; I don't know any young gay person who's on Facebook Live," Oselett said. "I think the city is very much fumbling all of this, and I am terrified about Market Days (a gay street festival in Lakeview East that attracts hundreds of thousands of revelers), which is coming up."
Oselett said there are behavioral changes people can make to be more vigilant during the outbreak. Schneider, for his part, noted that people with monkeypox have posted online about the disease's horrific symptoms (such as proctitis, or swelling of the rectal lining) and pain from gory lesions breaking out over appendages and sensitive body parts. He nevertheless thinks that "people have to be dropping dead for people to change any sort of sexual behavior."
"I have heard that people are not sharing their vaping devices or not drinking from the same bottle," he said. "We don't yet know how much of the transmission is attributable to those types of activities, but there is some (risk), so that could help."
There are nowhere near enough vaccines in Chicago; Schneider estimated that perhaps 10% to 15% of high-risk people have gotten a dose of Jynneos. He foresees the outbreak "carrying on for a bit," but he did say that monkeypox appears to confer some protection after recovery from the disease.