mpox (monkeypox) is a disease caused by the mpox virus, which is in the same family as smallpox, although much less severe. Its name is characterized by the pox illness that occurs upon infection, leading to an outbreak of lesions spreading from the face to the rest of the body, including the genital areas.

mpox was first discovered in 1958 in a research monkey facility. The first case of mpox in 2022 was reported on May 7th in the United Kingdom and was linked to an individual who had recently traveled from Nigeria. The current outbreak has known cases in Europe, Africa and the Americas. The first case in the United States was on May 18, 2022.

According to the CDC, mpox (monkeypox) can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks. People who do not have mpox symptoms cannot spread the virus to others.

mpox can spread between people mostly “through direct contact with infectious rash, sores, scabs, saliva and respiratory secretions.” It can be passed on through extended physical skin-to-skin contact, including between sexual partners during intimate, close contact. This includes but is not limited to “activities like kissing, cuddling, or touching parts of the body with mpox sores.”

mpox sores can also appear on the mouth, vagina, or anus, but it can also spread through any kind of oral, vaginal or anal sex by touching the genitals or mouth of a person with symptoms of mpox who may have sores inside the body.

Risk of exposure is not limited to skin contact, the virus can also be spread through objects like clothes, bed sheets, sex toys, fetish gear, and other surfaces that have been used by someone with mpox.

Rash or lesions will typically begin to appear in 1-3 days after the initial fever, “often beginning on the face then spreading to other parts of the body.” However, be aware of skin rashes or lesions that may be isolated to one part of your body and if you note any unexpected or unexplained changes, see a healthcare provider. The CDC notes that mpox begins with:

• • Fever

  • Headache

  • Muscle aches

  • Backache

  • Swollen lymph nodes

  • Chills

  • Exhaustion

The incubation period lasts anywhere from 2-4 weeks, and individuals remain infectious until lesions have completely healed and scabs have fallen off.

• • Avoid skin-to-skin contact: Sharing direct and personal skin-to-skin contact should be avoided, and there is a higher likelihood of contracting mpox (monkeypox) at events hosted in enclosed spaces where people can be expected to have minimal to no clothing. Large outdoor events where people are fully clothed offer you more safety by minimizing your risk of exposure through skin-to-skin contact.

  • Sex: Think carefully deeply about sexual activity and how/if to have sex. Do not participate in any intimate activities if you have flu-like symptoms or have developed any unusual rashes or lesions on your body. (SEE THE SECTION BELOW ABOUT SEX)

  • Hand washing: Practice good hand washing, especially after encountering a person with mpox.

  • Avoid infected surfaces: With unwashed materials and objects that have been exposed to direct and intimate contact with someone who has mpox. The virus can be spread through prolonged respiratory secretions or contact with a lesion or rash, not only person-to-person, but through contaminated objects that have not been properly cleaned.

  • Mask up: Masks are encouraged to help prevent the spread through respiratory droplets in situations with face-to-face contact

  • Isolate: Quarantine yourself from others if you have become exposed to or infected with mpox. Avoid contact with those who have the infection.

  • Vaccine: HHS has ramped up testing and vaccine strategy with more than 200k doses to be distributed in the coming. (SEE MORE BELOW ABOUT VACCINE INFO)

  • Talk with your health care provider: Health officials recommend talking to your healthcare provider about getting the smallpox vaccine within two weeks of exposure to someone diagnosed with mpox.

Sex is a natural part of life. It’s important if you are engaging in sexual activity to know the facts. Here is how to best minimize risk and tips from the CDC:

• When to avoid sex: If you or your partner has or recently had mpox (monkeypox) symptoms,or you have a new or unexplained rash, immediately isolate and see a healthcare provider. In some cases, symptoms may be mild, and some people may not even know they have mpox.

• Contactless sexual activities: Reducing your chances of spreading the virus would include getting more creative in contactless sex such as virtual sex, or masturbation at least 6 feet away. Avoid kissing, cover lesions and rashes, and wash sheets, clothes and sex toys. Do not share sex toys.

• Communicate: Be transparent with sexual partners about any recent illnesses or new sores you’ve experienced and be aware of anything new on you or your partner’s body.

• Your protection will be highest two weeks after your second dose of the mpox vaccine. Reducing or avoiding behaviors that increase risk of mpox between your first and second shots are recommended. Consider a brief break of activities that may increase exposure the virus.
• Get contact info: Be sure to exchange contact info with any new sexual partner to allow for sexual health follow-up, if needed.
• Condoms: Condoms may protect your anus, mouth, penis, or vagina from exposure to mpox. However, condoms help but are not completely full proof in mpox prevention and do not protect other parts of your body.
• Raves, parties, clubs, saunas, bathhouses & festivals: events where there is minimal clothing, kissing, direct, personal, often skin-to-skin contact has some risk. Avoid any rash you see on others and consider minimizing skin-to-skin contact.
  
• Other parties: Spaces like back rooms, saunas, sex clubs, or private and public sex parties, where intimate, often anonymous sexual contact with multiple partners occurs—are more likely to spread mpox.
• For more information about health sex and mpox prevention visit the CDC resource.
  
• According to the World Health Organization, while mpox (monkeypox) transmission can occur in several ways, the main route of transmission in high-priority populations has been through sexual contact. Symptoms of early mpox cases can be confused with other STIs, such as syphilis and herpes. Be aware of this, as co-infection with mpox and STIs is common.
  Because of the overlapping populations of the mpox outbreak and those disproportionately affected by STIs and HIV, sexual health service providers should consider incorporating mpox diagnosis, treatment, and vaccination into existing services. Patients with a new rash or lesion, especially those who meet one or more of the epidemiologic criteria should be tested for mpox. This also is an opportunity to seek information regarding PrEP, HIV testing and HIV treatment such as Anti-Retroviral Therapy (ART).
  
  

To be clear. mpox (monkeypox) is NOT a “gay” disease. As we learned from the HIV epidemic,

framing it as a “gay” disease is misleading and hinders us from properly stopping the outbreak. Just like many members of our community, we’re concerned about the spread of mpox. We recognize that the virus has been able to easily spread through close, skin-to-skin contact within our community.

While mpox can spread to anyone, anywhere through close, personal, often skin-to-skin contact regardless of gender or sexual orientation, it’s true that health officials have tracked a substantial percentage of the cases among men who have sex with men.

Since this virus is typically passed on through direct contact once it's introduced to a community, it is more likely to spread through that community among those who are in close contact with each other.

It’s important to recognize that

Health officials note that high rates amongst MSM could be due to gay men being more proactive toward their sexual health (seeking testing, treatment, knowledge sharing) compared to other communities. Over the past several weeks, we’ve seen the LGBTQ+ community doing what we’re best at: caring for each other, raising awareness and acting on sound public health guidance.

We’ve seen historical and systemic discrimination when it comes to delivering effective prevention and treatment especially to these members of our community. It’s critically important that care providers, public health officials and the media continue to provide a clear, scientific, evidence-based response to prevent the spread of misinformation.

The LGBTQ+ community has for decades been faced with stigma in health care offices and news stories alike just because of who we are. This reality is compounded for people of multiple marginalized identities. Causing unnecessary fear will potentially endanger lives and lead to destructive policies. Every person, no matter your sexuality or gender identity, should take proper precautions and listen to guidance from health officials in order to stay safe.

• We urge public health officials to prioritize outreach to LGBTQ+ communities of color and people living with HIV.

• This means prioritizing vaccine sites in key LGBTQ communities, partnering with minority-led and community-based organizations to ensure a more equitable distribution and ensuring that these leaders are at the table.

Regarding illness after infection, the available data indicates that people with advanced and unmanaged HIV can be at a higher risk of severe or prolonged disease. This is why it’s extremely important to seek care and follow your prescribed treatment if you’re living with HIV.

Reports from European countries where most patients are on effective ART have noted no deaths or evident excess in hospitalizations thus far among people with HIV and mpox.

Additionally, the WHO has stated that “people with HIV…who take antiretroviral therapy and have a robust immune system have not reported a more severe course of disease.” More info on mpox (monkeypox) and HIV can be found here

With a greater supply of mpox (monkeypox) vaccine, the CDC announced it is expanding eligibility for the vaccine. This shift in vaccine strategy will help to ensure that those who are at the highest risk for mpox receive the vaccine before exposure. CDC is also endeavoring to make sure that vaccine distribution and access is equitable for those who need them.

As of September, vaccine priority will be based on the following:

• Gay, bisexual, and other men who have sex with men, transgender or nonbinary people who in the past 6 months have had:
  • A new diagnosis of one or more nationally reportable sexually transmitted diseases (i.e., acute HIV, chancroid, chlamydia, gonorrhea, or syphilis)
  • More than one sex partner
• Sex in association with a large public event in a geographic area where mpox transmission is occurring
• Sexual partners of people with the above risks
• People who anticipate experiencing the above risks

A treatment for smallpox, TPOXX, is available to people who are experiencing extreme pain from lesions with plenty of national supply. Please visit the vaccine tracker or contact your local health department to see if vaccines are offered in your area.

JYNNEOS (also known as Imvamune or Imvanex) is one of only two currently licensed vaccines in the United States to prevent smallpox have been approved by the U.S. by the FDA for the prevention of mpox. More than 800,000 doses of the JYNNEOS vaccine have been administered since May. State and local health departments will also have the option to use the ACAM200 vaccine. However, that vaccine carries greater risk of certain serious side effects.

Post-exposure: The CDC recommends the sooner you get vaccinated the better, especially if you believe you have been exposed within the last 4-14 days as the symptoms can still be lessened. If you are past this time-frame, or have already recovered from mpox, experts still recommend the vaccine for effective protection against future infection. More information about vaccines are here.