Bringing Sexual Health Care Where People Have Sex

heyn Saturday, June 29, 2019, a group of more than 200 gay and trans people gathered in New York City to celebrate the city’s big world pride weekend. They all came to a party called NYC Inferno which was known for sexual activities. Around midnight, they gathered in front of the venue, rejoicing as an artist led them in an interactive performance. Within moments, everyone was singing the refrain: “We’ve got to keep each other alive, because ain’t nobody else gonna do it.”

In keeping with this care-based ethos, NYC Inferno, and all other queer sex-based venues in NYC, were quickly closed in July 2022, when cases of monkeypox (MPV) increased in the United States. The terror of MPV was almost unfathomable to many, including the queer community: excruciating pain, horrific wounds, and a treatment that few doctors could prescribe.

When NYC Inferno relaunched on September 17, 2022, attendees first stopped at a white van parked near the venue to house a mobile clinic offering the Jynneos-MPV vaccine. Xynos, safe and effective, requires two doses for complete immunity.

As executive lead at NYC Health + Hospitals, a community organizer and queer scientist, and the creator and host of NYC Inferno, we are part of a team that provides free, subcutaneous Genios vaccines on-site at commercial sex venues in NYC. Provides supplements. This summer, MPV vaccination was severely limited by supply as cases rose rapidly. In New York, the Department of Health partnered with community organizations and set up large-scale vaccination sites, even though demand continued to exceed supply during the fall. The success in flattening the MPV epidemiological curve, and the continued low and declining case counts even as sexual behavior is returning to normal, highlights the power of bringing sexual healthcare directly to affected communities and the places where they congregate. There are

Read more: How the monkeypox virus does and does not spread

People who participate in group sex tend to have a greater number of sexual partners. Providing preventive care to this group can help prevent infectious disease—from HIV and STIs to MPV—not only in people who participate in sex parties, but in everyone else in their sexual networks. By getting a vaccine to help prevent MPV, this community has shown that quirky pleasure and community care can go hand in hand.

After initially closing on July 14, 2022, gay meetups in NYC reopened on September 3. Community members wanted to ensure that people could be safely vaccinated on site. NYC Health + Hospitals—in collaboration with NYC’s Department of Health and Mental Hygiene’s sexual health team, community experts, event hosts and participants—acted quickly to address this need. To date, NYC has given out more than 3,000 doses of the MPV vaccine at nearly 60 mobile sites across the city—from queer health clinics and community pride centers to sex parties and raves.

Our model of collaboration at the NYC Inferno and other sex parties inspired the rapid use of vaccines at safe, accessible sites. On September 17 in Brooklyn, after the NYC Inferno reopened, and NYC allowed access to the second Genios dose on site, 60% of party-goers received a dose of the MPV vaccine in a mobile unit.

At GBU, a weekly sex party for queer men, mobile vaccine delivery was proving efficient, but we needed to adjust our model to meet the needs of the community. When the party reopened on September 3 and only the first Genius dose was available, only 13 vaccinations had been administered. When we talked to event attendees, most reported that they had already received one vaccination—and because of NYC’s vaccine standards, they were not eligible to receive a second dose. It was clear that the demand for the second dose was high. It was also clear that participants recognized the risk they faced and wanted complete protection.

The community advocated and successfully persuaded NYC health officials to allow a second subcutaneous Xenios dose at commercial sex sites. The following week at GBU, health workers administered 82 vaccinations, mostly second doses, to 40% of those in attendance. The following week, health workers provided a further 57 doses, reaching 43% of those present that night. NYC Inferno had the most vaccine uptake of any MPV mobile vaccine event in the city, with 90 shots given in one night.

To address racial disparities in MPV vaccine access and cases, we partnered with a host of nightlife events for queer people of color, like Papi Juice and Trappy Hour, that provide dozens of doses on-site. The NYC Department of Health also provided outreach teams on-site to educate community members about both MPV and the vaccine.

NYC Health + Hospitals’ mobile fleet clearly met a need—73% of doses delivered by mobile units at high-risk events like sex parties were second doses. Low-risk events promoted widespread uptake of the first dose, and high-risk events proved necessary to provide high immunity to those most at risk of MPV infection. Extending the first dose to the queer community at large, and ensuring full protection of those with the most number of sex partners, have both helped keep daily MPV cases in NY in the single digits through the fall.

Research on MPV suggests that preventing infection among those most connected in sexual networks is essential to protect the community at large. While our work cannot directly determine the efficacy of the Geneios vaccine, which is not currently known, high vaccine uptake in NYC among those most at risk including a second dose may result in reduced transmission of MPV Happening, even sex parties are resuming.

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On November 5th, one of us staff at the GBU party asked if people needed a dose of MPV when they were coming in. 20 minutes after someone was escorted to the mobile van, a freshly vaccinated man returned to the party, a big smile on his face.

“Thank you so much for helping to keep our community safe,” he added

Health care, when it’s so seamlessly integrated into your life, can be a joy. Based on our experience with MPV vaccines, and with parties like GBU and NYC Inferno, queer people want to protect themselves. Gay people want to enjoy parties and have sex with minimal risk of disease. Mobile healthcare units meet community needs by bringing people In cares that they need and is genuinely excited about.

While NYC Health + Hospitals’ mobile units only administer MPV vaccines at commercial sex sites, we envision a sexual health care pop-up model that could provide resources for HIV prevention routine vaccinations for COVID-19, influenza , and can even prevent bacterial sexually transmitted infections.

Sex parties attract people of multiple sexes. Providing direct care in these places is an opportunity to reduce the dishearteningly high rates of infectious and sexually transmitted diseases and HIV in NYC.

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