Monkeypox is not a sexually transmitted disease. But it does spread through skin-to-skin contact—and therefore, during sex. The disease has currently spread overwhelmingly among men who have sex with men, and the LGBTQ community has been at the forefront of trying to contain and control infection, advocating for more vaccinations and testing, as well as information about the seriousness of the disease.
Yet once again government response has been slow, including in countries like the US that have a stockpile of vaccines and testing capacity. This has left many gay and bisexual men exposed to the risk of contagion, even though more doses have been distributed in areas with high number of cases—such as New York City, where more than 1,250 cases have been detected (given the scarcity of tests, the actual number of cases is likely to be several thousands more).
The World Health Organization (WHO) has asked gay and bisexual men to take steps to reduce the spread. “For men who have sex with men, this includes, for the moment, reducing your number of sexual partners, reconsidering sex with new partners, and exchanging contact details with any new partners to enable follow-up if needed,” said WHO’s head Dr. Tedros in a press conference.
But queer activists have a better idea than that: Sex pods.
The way a sex pod works is pretty intuitive. During covid, some people elected to be in small groups, having dinners and going on holiday together in a close circle of individuals who only hung out unmasked with each other. Now, monkeypox pods are the same, but with sex instead of breathing in one other’s droplets.
People who are in a sex pod have sex with others in the pod, and only with them. Assuming none of the pod members have monkeypox when the pod is established, and that all are able to avoid contracting it from others (by direct contact, or, for instance, through infected fabrics), then they can all have plenty of safe sex with one another.
While not a perfect solution, this kind of harm reduction approach can make up for the temporary absence of sex parties, and gatherings in clubs where skin to skin contact with strangers would be harder to avoid. “I’ve been talking to a bunch of people who host nightlife and sex parties, and they’ve been constantly asking, ‘do we shut down?’ And the answer eventually was yes,” says Joseph Osmundson, a professor of biology at New York University and queer health advocate. The community has been very receptive to the advice to hold off on sex parties for a couple of weeks until more vaccines are available. Some party organizers even suggested they might require proof of monkeypox vaccination when opening again, he said.
Still, he says, it’s not reasonable—or fair—to expect people stay away from sex until the response to the monkeypox infection catches up with the emergency. “You know, gay sex is a constant of human life. If your public health strategy involves telling people for a long period of time not to have sex, that public health strategy will fail,” says Osmundson.
Sex podding is harm reduction in two ways: it mitigates the risk of monkeypox spread; and it minimizes the sexual sacrifice demanded from the most vulnerable community. “Ways to minimize the actual risk while being very pleasure positive, pleasure forward, sex positive, sex forward, sex-worker positive and forward are really important,” says Osmundson. “And sex pods are a great potential solution.” This, however, isn’t an option for everyone. For instance, for sex workers of all sexual orientations, limiting the number of partners could unsustainable, so vaccination becomes even more essential.
While condom usage is not effective in preventing the spread of monkeypox, other practices, too, can help contain the disease without giving up sexual pleasure. For instance, says Osmundson, some people have started including skin checks for monkeypox rashes as part of their foreplay. Self-checking, too, is important, as is asking questions of new partners, life whether they have any monkeypox symptoms (which include flu-like ones as well as rashes and lesions), if they have had anonymous partners, or if they have been going to saunas, clubs, and other venues where the virus might spread.
“We’re super-duper used to this,” says Osmundson. “We ask about HIV status all the time, it’s sort of a routine part of our chat before hookup. So this should absolutely be incorporated into that type of conversation—without stigma, without shame, just as a part of our routine sexual health practices.”