Mpox worries return ahead of Pride, a leather convention offers hope

CHICAGO — The purple sandwich boards scattered throughout the historic hotel hosting the annual International Mr. Leather convention bore a stark warning: “MPOX ISN’T GONE.”

Health officials and LGBTQ+ organizations treated the convention as an opening salvo in the race to stave off another outbreak of the virus that ripped through the gay community and infected more than 30,000 Americans last year. They sought to vaccinate attendees and raise awareness at the event, one of the first large gay gatherings to kick off a summer of Pride festivities and travel — and with it, sexual activity that drives mpox transmission.

Chicago has recorded 31 infections in the past five weeks, raising alarms because two-thirds of the cases were in fully vaccinated people. And the leather convention, drawing thousands to celebrate the sexual subculture over Memorial Day Weekend, risked further spread to travelers from around the world.

“Any inaction on our part would be catastrophic,” said Antonio V. King, the LGBTQ+ health and outreach director for the Chicago Department of Public Health.

Public health officials are monitoring whether Chicago represents an isolated incident or marks the start of a second summer wave. The coming weeks will either reveal the resilience of their vaccine-centric campaign to bring last year’s outbreak under control or offer a humbling reminder that viruses are formidable and unpredictable foes.

About a quarter of people considered at risk for contracting mpox are fully vaccinated, according to the Centers for Disease Control and Prevention, although the rates are far higher in major cities that saw the largest outbreaks.

Health officials worry low immunity in some swaths of the country and people letting their guard down because they think mpox has vanished could spark a resurgence.

“No one at this point is resting on their laurels,” said Demetre Daskalakis, who leads the White House response to mpox, formerly named monkeypox.

It’s difficult to sustain public interest in health threats, especially when gay Americans faced three consecutive summers upended by COVID and then mpox. The current national tally of mpox cases is small, with 81 people infected since April, a slight uptick following a winter decline. More cases could be going undetected because attention to mpox has waned and some infections manifest as inconspicuous bumps. Full protection from vaccines take six weeks to kick in, so health officials need to act before a spike.

On the front lines to prevent another wave, workers from Howard Brown Health manned a booth to tout vaccines at an entrance of the convention’s leather market, between Speedo-clad young men promoting an app for casual sex and vendors hawking mesh tank tops.

Employees of Howard Brown, which serves Chicago’s LGBTQ+ community, asked attendees who stopped by for free condoms and lube whether they were up to date on their mpox vaccine, a twoshot regimen. To their surprise, nearly everyone said they were. So many people asked whether they should get a booster shot that a supervisor posted laminated cards noting third doses are not recommended. One worker who spent ten minutes walking around the hotel to advertise a mobile vaccine clinic could not find a single unvaccinated person.

That offered hope for quashing another outbreak.

“There is this preconceived notion that most people that belong to this sort of community don’t really take too much caution when it comes to sex,” said Ivan Capifali-Cartagena, a bilingual outreach health educator at Howard Brown, after a full day of talking to people who stopped by his booth. “That camaraderie, looking out for one another … was pretty satisfying to me.”

For many gay men, the trauma of last summer’s mpox outbreak is seared into memory. It created chaos and fear in a season embraced as a time for gay joy. Men who contracted mpox were forced to quarantine for weeks, losing income and facing stigma and ridicule. Others put their sex lives on hold for fear of infection.

Experts credit the gay community for taking mpox seriously and playing a key role in nearly vanquishing the virus through behavioral change and vaccination last year. Now, convention attendees were alert to its return.

One man walking through the leather market mentioned the Chicago cases to a friend, fretting that even more were probably going undetected. Another told a health worker that he had seen a tweet from a fully vaccinated porn star who contracted a mild case with a subtle lesion on his hand, questioning the official tally. “If there’s one cockroach, there’s 100 more,” he said.

And many considered the risks of mpox before coming to the convention, where people feel liberated to wear leather harnesses, masks and full-body latex or rubber suits and have casual sex after hours without judgment.

Ajmal Millar, a Chicago artist who partied with a leather club for men of color, posted on Facebook that mpox is back and people should get vaccinated and be careful who they choose as sex partners. He and other members of his club worried Black men would again bear the brunt of another outbreak with vaccines harder to access in majority Black neighborhoods and stigma dissuading discussion about the virus.

Millar, 36, described the toll of mpox in his South Side community as something out of a horror movie: People developing marks on their faces, some unable to go to the bathroom without intense pain and friends disappearing for weeks on end without explanation. He received the first dose of his vaccine late last summer. As a Black man, he said, he had misgivings about returning for a second dose as the mpox wave receded because he distrusted the medical establishment that has historically mistreated African Americans.

But the recent rise in Chicago cases swayed him to get a second dose and push his friends to take the virus seriously too.

“Let’s not allow these things to deplete us in a way that we just are just sitting ducks,” Millar said, following a health discussion hosted by the leather club in its hotel suite. “Let’s make sure we’re taking care of ourselves … and make sure we’re being that friend that is going to make those uncomfortable posts or have those uncomfortable conversations during dinner or cocktail hour.”

Even with convention attendees largely vaccinated, there’s still potential for spread. The vaccines do not guarantee protection.

Studies last year estimate that two doses of the Jynneos vaccine is 66% to 86% effective in preventing mpox, with lower protection after just one dose. They do not answer the crucial question of how long protection lasts. Health officials are examining data from Los Angeles and Washington, D.C., to assess whether immunity is waning and if booster shots are warranted.

Some attendees remain unvaccinated because they faced difficulty getting shots last year.

While shopping at the

leather market, Daniel Williams, a 30-year-old adult performer, said he worries about contracting mpox. But he did not get vaccinated in his hometown of Washington last summer because he wasn’t getting out as much due to health issues and had heard about long lines to get shots. He knows cases are rising again and an infection could put him out of work.

Ultimately, he decided to record sex scenes during the convention with people he trusted and skipped sex parties, hoping he would not contract the virus.

“When you … see all these people having fun, the fear of missing out kicks in,” Williams said, “and you kind of stop paying attention to it.”

Despite breakthrough cases, Chicago’s recent mpox uptick also offers hope that the vaccines are working as intended. No other community has reported a significant increase. The Chicago cases are mild with smaller lesions. Weekly new cases have stayed steady instead of increasing exponentially, suggesting the virus is hitting a wall and will not spark an explosion of cases.