I spent hours on the phone last week trying to figure out how I, a Pittsburgh-based sex worker, can get a monkeypox vaccine in Allegheny County. While I have not been exposed to the virus — and while the reported numbers are still relatively low here (there have been 20 cases as of July 27) — an integral part of my job is staying on top of my sexual health.
Despite persistent (and harmful) myths that sex workers are disease vectors (The Page Act of 1875, the first U.S. anti-immigration policy, targeted Asian women as sex workers spreading STIs, for example), most people who make a living in the sex industry are highly motivated to take all available measures to mitigate risk. After all, it isn’t just our personal health that is on the line, but also our means of survival — our income. Coming down with monkeypox or STIs (not to mention COVID) puts us out of work and there is no paid time off for sex workers.
While monkeypox has not been defined as an STI, the virus is spread through close, intimate contact (such as cuddling, kissing, and sexual contact), as well as touching contaminated materials such as clothes. Since sex workers often come into physical contact with clients, this puts us — as well as our partners, our clients, and our clients’ partners and spouses — at risk.
I tried to gain access to the vaccine by first reaching out to an infectious disease doctor, who told me that they do not have any information yet on how to access the vaccine. I moved to East Liberty’s Allies for Health and Wellbeing, which didn’t yet have it, though they are now able to offer the vaccine in a limited capacity after recently expanded access. I called Central Outreach Wellness Center on the North Side and, while they have it and told me they agree that it is a good idea for active sex workers to be vaccinated, they informed me that the commonwealth of Pennsylvania will not allow them to give it to anyone who hasn’t had a known exposure.
Having no luck with the local clinics, I moved on to the Allegheny County Health Department.
While I would rather walk on glass than call a governmental agency and tell them that I am a sex worker, I didn’t feel like I was left with any other option. The person I spoke to told me they understood why administering the vaccine to sex workers should be a top priority and went out of her way to fast-track me for a vaccine appointment — saying the scheduler would get back to me right away — only to call me back 15 minutes later to inform me that she was told I don’t qualify.
When I asked what I would have to do to qualify, she said that I would have to be a “man having sex with other men.”
While up until this point, the majority of the people who have been infected with the virus do fit this description, we know that men who have sex with other men don’t only have sex with other men, not to mention that this attitude increases stigma and violence against an already marginalized population. These guidelines “put an entire disease on one community and doesn’t actually let us address the disease moving from one person to another, making it a worse public health crisis than it needs to be,” according to GLAAD’s CEO Sarah Kate Ellis on NPR.
We also know that the government has a long history of being sluggish to the health needs of stigmatized populations. After all, GLAAD only exists as a response to the government’s botched response to the AIDS crisis. I believe it is impossible to live through both the AIDs epidemic and the COVID crisis and have any faith that the government will protect marginalized populations from immanent health risks, that it won’t just allow folks to suffer or die through inaction.
While the World Health Organization has declared monkeypox to be a global public health emergency, sex workers who are working to be proactive in protecting ourselves, our partners, and our clients against the virus are, as of now, being actively thwarted by the state. This feels perverse when sex work continues to be heavily stigmatized and criminalized in part because of the perception (by the government no less) of sex workers as disease vectors.
While it may not be immediately obvious, sex workers live among you. We are parents, partners, friends, and colleagues who want to safely do our jobs and prevent the further spread of this disease. If the government doesn't start helping us protect ourselves, it isn't only failing us, it's failing you, too. And it won’t be our fault.
UPDATE: The day after this article was published, Jessie Sage was able to schedule a vaccine appointment. As reported in VICE on Aug. 5, "It was only after making all of these calls, and writing an article for the Pittsburgh , that she was finally able to get a vaccine appointment."
Jessie Sage is a Pittsburgh-based sex worker and writer. She co-hosts podcasts On the Whorizon & The Sex Industry Book Club, and is the co-founder of Peepshow Media. She’s currently writing her first book with West Virginia University Press.