This May, it appeared among gay men, especially those who had visited four venues: the Darklands leather fetish festival in Belgium; the annual Pride Festival in Spain’s Canary Islands; a gay rave at Berlin’s Berghain techno club; and the Paraiso sauna in Madrid, which, since it had darkened cubicles for orgies, a bondage cell and a bar, was really more of a huge sex club than a spa.

Even though one “sex-positive” party after another has turned into super-spreader events, there has been no willingness by the organizers of such parties to cancel or even reschedule them until more men can be vaccinated.  June was Pride Month in New York and cases are surging in the city now. Two recent parties in San Francisco,   Electroluxx Pride and the Afterglow Blacklight Discotheque had cases linked to them. And yet more events, like Provincetown Bear Week are going forward anyway.

Outside of Africa, the disease has not killed anyone yet. But for some victims, the pain—especially from pustules inside the mouth or rectum—is so severe that it requires hospitalization. Others feel miserable for weeks; a few get permanent scars. Also, those with monkeypox are supposed to stay in isolation until all the pox crust over and the scabs fall off, which can take up to a month.

The negligible fatality rate won’t necessarily persist if the virus escapes its current network: mostly young, mostly healthy adult men.

In five subsequent articles, I’ve made some fairly strident suggestions.

First, that we talk frankly about risky gay male sex networks instead of fretting about stigmatization. Stopping an epidemic is more important than greenwashing it. Second, that this summer’s Pride celebrations for men (not the parades, the “sex-positive” after-parties) should be rescheduled until autumn, when many more men will be vaccinated and rapid tests should be available to enable testing right at the party door. Third, that we stop pretending that ring vaccination could ever work and instead offer vaccine to all men with multiple sex partners, and to all sex workers. (Vaccinating the “ring” of contacts around each case is impossible when men have anonymous sex—they don’t know who their contacts are.) Fourth, that we roll out both the Jynneos and the ACAM2000 vaccines and screen men for the risks posed by the older vaccine. Fifth, that the government offer a month’s shelter to all men who test positive so they can isolate safely under medical surveillance.  (Not all gay men live fabulous lives; some have to sell sex to eat and pay rent.)