During the early days of the AIDS crisis, LGBTQ bars around the country became hubs of activism and support for the community at large. Drag queens held shows raising money for those living with HIV and AIDS. People grieved together in bars and clubs. And as public health information became available, bars offered sex education materials and classes. Those efforts paved the way for what are now considered common bar practices, like being able to walk into a drag bar in New York and listen to a hosted talk about the benefits of pre-exposure prophylaxis, or PrEP, a medication that reduces the transmission of HIV. Many bars around the country include a cork board with testing information or a fishbowl full of condoms.
In recent months, Multnomah County health officials have partnered with the area's LGBTQ bars once again, this time tackling a different disease: MPV, sometimes called monkeypox. At bars like CC Slaughters and Scandals, Portlanders will find information about preventing the spread of MPV, symptoms, getting tested, and more.
"From very early on in terms of responding to the HIV epidemic, queer businesses and queer establishments have been valuable partners," says Jaxon Mitchell, HIV/STI prevention and intervention manager for the county. "That never stopped."
MPV is a disease caused by a virus that involves a commonly painful or itchy rash that resembles pimples or blisters. Some people who get MPV also experience flu-like symptoms including fever and swollen lymph nodes. It's primarily spread through prolonged physical contact, though it can be spread through bodily fluids or through exposure to contaminated bedding or clothing. The most recent MPV outbreak in the United States has spread rapidly through communities of men who have sex with men, though categorizing MPV as a sexually transmitted infection would be inaccurate. That's the kind of information Multnomah County is trying to get out to the public in general - in particular the LGBTQ community, which is being disproportionally affected during this outbreak.
"We're not worried about [MPV] being an STI," says Christopher Hamel, a programs specialist on the HIV/STI Preventions Team and community testing coordinator. "There's a lot of talk about whether it's a 'gay disease,' but there's no such thing as a gay disease. We want to talk about where to go for information, and to make sure that information comes from a source that is as close and trusted as possible."
To do that, Multnomah County officials have been leaning on those longstanding relationships with Portland LGBTQ bars and businesses. To start, health officials have been providing bars with public health materials related to MPV - think flyers and pamphlets - and talking through the information within those flyers and pamphlets with the bartenders and owners at these bars. Typically, that covers how to keep customers and staff safe.
"Walking into these places wearing a county ID, saying you're from the health department, people know why you're there, and they're ready to listen," Hamel says. "It's really special. It's far more personal than I think the average person might expect."
For now, that's a start, but the health department is hoping to go further. Currently, they're developing a train-the-trainer-style program related to public health, creating ambassadors within the queer community to help share the information. Building that curriculum will take time, however; the longer goal is to create information for a specific community without implying that it's exclusive or endemic to that community.
"It takes a lot of nuance to thread that needle, to make sure the accurate medical information is available to people," Mitchell says. "Something we've learned over the years is that when messaging isn't precise enough, that can cause stigma, because stigma comes from fear."
The emergence of the MPV outbreak during the ongoing COVID-19 pandemic has forced health officials to compare and evaluate their strategies for managing public health during the spread of a virus - though MPV and COVID-19 aren't exactly comparable. Beyond the difference in the rate of spread, the required shutdown of bars and restaurant dining rooms at the beginning of the COVID-19 pandemic left the health department without one of many spaces to disseminate health information. Now that those spaces have reopened, queer bars can reclaim their role as places for the community to connect and support each other.
"As a gay man myself, the thrill, the sense of community, it still happens when I go to a gay bar - we were denied that for so long," Hamel says. "There are people coming out to these spaces, we want to honor that while also honoring that community spaces are great places to share information."
To learn more about MPV, check out the Multnomah County fact page.