Monkeypox Virus (MPX/MPV)
Updated August 3, 2022
Since May 14, 2022, monkeypox virus (MPX) has been reported in several countries that don’t normally have MPX, including in North and South America, the U.K., and Europe. As of now, the number of people who’ve tested positive for MPX is small but increasing quickly. Knowing this information can keep us all alert and aware of any unusual symptoms so we can prevent the spread.
Who is this impacting?
MPX can affect anyone of any gender identity or sexual orientation. However, it’s particularly impacting cisgender men who have sex with men and their sex partners.
While there is limited data on the impact of MPX on trans and non-binary people, those who may be in queer sexual networks should know this info as well.
What are the symptoms?
Symptoms can appear between 5 to 21 days after exposure, and can include:
- An unusual rash or sores, which often start on the face or mouth then spreads to other parts of the body, including your genitals (dick, vulva, testicles), butt (including inside your ass), or inside your vagina/front hole
- Headache, muscle aches, and back ache
- Swollen lymph nodes, including in your throat, armpits, and groin
- Exhaustion (fatigue)
The rash or sores typically come after the other symptoms listed above. Someone can be contagious as soon as any of the above symptoms start. Symptoms can last up to 4 weeks with most people recovering from mild illness within that time.
If you have unusual sores or a rash, get immediate medical attention. You may need to isolate for up to 21 days to prevent passing the virus on to others.
How is the virus spread?
- MPX is spread through close contact, like touching someone’s rash or sores, and sharing bedding or towels, or through respiratory droplets (kissing, coughing, sneezing).
- It is being spread during sex since it often means having close contact, extended time face-to-face, and touching someone’s sores on their skin, genitals (dick, vulva, testicles), butt (including inside), inside of a vagina/front hole, or mouth.
- Condoms are not sufficient to prevent monkeypox transmission. If the rash is only on your genitals or inside your butt, condoms may help reduce the likelihood of developing sores in those areas, which are extremely painful. However, condoms alone are likely not enough to prevent monkeypox. You still may be exposed if you have skin to skin contact or share bedding/towels.
How can I reduce my risk of infection during sex?
Based on available data about how MPX may be spreading in our community, BHOC has the following suggestions to keep yourself and your sex partners as safe as possible:
- Be alert and share this info. As of now, the number of MPX is small but growing quickly. Knowing this information could prevent you from getting or spreading the virus.
- Ask your sex partners about symptoms. See if they have had any unusual rashes or sores in the last 3 weeks. Here are some easy ways to ask:
- “I’m down to hookup, but I want to make sure both of us are feeling good since monkeypox is going around. Have you had any recent rashes or sores?”
- “I want to make sure we are both on the same page with monkeypox. I haven’t had any new rashes or sores and haven’t been feeling sick. How about you?”
- Stay connected: Even if you’re into anonymous hookups, try to have a phone number or way to get in touch with someone in case you need to reach each other if either of you develop symptoms or gets diagnosed with MPX.
- There are lots of ways to take care of yourself. Some people are pressing pause on meeting up with new people. If you still want to meet up with others, there are ways to reduce the chance you could get MPX, like cam sex, phone sex, jerking off with someone from a distance, being in large groups outdoors (especially if you have clothing on), or forming an exclusive pod of sex partners.
- Consider using condoms as a way to avoid painful sores on your genitals: Condoms are not sufficient to prevent MPX transmission. If the rash is only on your genitals or inside your butt, condoms may help reduce the likelihood of developing sores in those areas, which are extremely painful. However, condoms alone are likely not enough to prevent MPX. You still may be exposed if you have skin to skin contact or share bedding/towels.
- If you receive a notification from someone you had sex with, take it seriously. Call your local health department to get connected to a vaccine. It also works the other way. If you are diagnosed with MPX, be sure to also let any sex partners know so they can make sure those exposed can get care.
- Notice if you develop symptoms. People are not known to be infectious until they have symptoms; but, keep in mind that someone may have sores in their throat, ass, or vagina/front hole and not know it.
- Stop the spread. If you don’t feel well, take a break from sex. If you live with someone, you may need to isolate yourself from them if you are positive for MPX.
- It’s okay to take a break. If you’re anxious about MPX or worried about your health, it’s okay to wait on meeting up until you have more protection from the vaccine or whenever you’re ready.
Here’s a video from the CDC on what all sexually-active people should know about MPX:
How can I reduce my risk of infection with other close contacts and at large gatherings?
- Make informed choices about attending large events. If you’re in large crowds where people are wearing minimal clothing (like at Pride events, saunas, clubs), be aware of how much skin-to-skin contact you may be having. Try to minimize your contact as much as possible. Read more from CDC about attending large gatherings.
- If you receive a notification from an event organizer, take it seriously. Call your local health department to get connected to a vaccine. It also works the other way. If you are diagnosed with MPX, be sure to also let any organizers of events you attended know so they can make sure those exposed can get care.
- Stop the spread. If you don’t feel well, take a break from going out to bars, gyms, clubs, and other events. If you live with someone, you may need to isolate yourself from them if you are positive for MPX.
Who should get vaccinated?
There are vaccines available for MPX. Vaccines in most places are prioritized for those who have already been diagnosed, and now are being offered to those who have been exposed to reduce the severity of symptoms.
Some places are now allowing people to get a vaccine to prevent MPX, even if they haven’t been diagnosed with or exposed to it. Reach out to your local health department to find out if you’re eligible for this option. Additionally, here is a state-by-state resource with vaccine availability information.
Most people living with HIV will be able to get vaccinated with the Jynneos vaccine. Check with your doctor and send them this CDC guidance in case they might not be up-to-date.
For people who are immunocompromised for any reason, ask your medical provider if it is safe for you to get the Jynneos MPX vaccine.
If you’ve already had monkeypox, please see this info from CDC.
If you’ve had the smallpox vaccine, please see this info from CDC.
When does the vaccine start protecting me from MPX?
Vaccines can give you protection from MPX, but not immediately after you get a shot. Continue practicing harm reduction for the timing shown below when meeting up with others and in your sex life.
If you’ve only received 1 dose of Jynneos:
Many places that have Jynneos vaccines are only giving the first dose right now. One dose of Jynneos does offer some protection, but not right away.
- The vaccine needs time to build up your immunity.
- Waiting a few weeks is more protective than waiting a few days.
Keep a look out for information from the location where you got your first shot so you can get your second shot as soon as it becomes available. Getting two doses of Jynneos will give you the most protection from MPX.
If you’ve received 2 doses of Jynneos:
People are considered fully vaccinated about 2 weeks after their second shot of JYNNEOS.
If you’ve had ACAM2000:
People are considered fully vaccinated about 4 weeks after receiving ACAM2000.
Can I get tested for MPX?
Some labs are offering MPX testing, but it is best to see a healthcare provider or go to your local sexual health clinic so they can check you for MPX.
They can also test you for STIs while you’re there, in case your symptoms aren’t caused by MPX. We always recommend that if you’re sexually active you get tested every 3 months for routine HIV and STI testing.
When should I get medical attention?
If you or any close contacts (from the last 21 days) have unusual sores or a rash, go see a healthcare provider either at:
- A local clinic (find your closest one here) OR
- With your healthcare provider.
Remind your provider that MPX is circulating. Sometimes the rash and sores can be confused with sexually-transmitted infections, like herpes and syphilis.
If you currently have monkeypox but are dealing with severe pain and/or belong to a high-risk community, you may benefit from treatment (TPOXX).
What is the treatment?
- If someone told you that you have been exposed to MPX, you can call your local health department to get a vaccine, which may keep you from developing severe symptoms.
- If you have been diagnosed with MPX and currently have sores, are experiencing pain, issues with using the bathroom (bowel movements and peeing), or other discomfort, you can ask a healthcare provider for TPOXX, an antiviral medication that helps reduce severe symptoms. Here’s how to do that:
- Let your provider know that the CDC recently updated guidance on July 22, 2022 to make TPOXX medication much easier to access. Share this link with them since the guidance recently changed and they may not be up-to-date.
- Providers can fill out the required EA-IND forms after you begin treatment.
- Virtual appointments are allowed to get prescriptions for TPOXX.
- If a provider refuses to prescribe TPOXX, ask them to document their refusal of treatment in your medical chart. If possible, also send a message after your appointment to your provider (either through voicemail or a patient portal) summarizing the visit, including the refusal of treatment.
Who should I tell about my MPX symptoms or diagnosis?
Testing positive for anything–whether it’s an STI, COVID, or MPX–can feel heavy or scary. One of the most important things you can do if you get diagnosed with MPX is to tell your sex partners, people you live with, or anyone else you’ve had prolonged, close contact with from the last 3 weeks. That way, they can get tested and potentially receive treatment and isolate to prevent passing it on. Here are some people you may need to tell:
- Sex partners
- Partners you live with, roommates, or family members in your household
- Owners or organizers of parties, bars, clubs, events, or bathhouses that you’ve attended
- Sex work clients or anyone you had survival sex with
- Others people who you have had close contact with
Here are some ways to talk about it if you want to send a text or message someone about your positive result. Your healthcare provider you see may also want the information about your close contacts so they can follow up with them as needed.
You can also send an anonymous text letting people know you were diagnosed with MPX at TellYourPartner.org.
What happens if I get diagnosed with MPX and have a detectable HIV viral load, am older, or am immunocompromised?
For people who have a weaker immune system, MPX symptoms can last longer and you may experience a longer recovery. You also might also be contagious to others for a longer period of time. Go to your healthcare provider to get support.
At this time, people living with HIV who are undetectable are not considered at higher risk for prolonged infection of MPX or any other complications related to the monkeypox virus.
People living with HIV who are not taking HIV medications are at higher risk for these complications.
People living with HIV and people who are immunocompromised could still benefit from treatment (TPOXX). Talk to your healthcare provider about any potential drug interactions.
What can I do to support the MPX response?
As we learn more, we will be updating this page. For more detailed information, check out your state or local health department’s website and the CDC.