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Mpox & HIV

Here is the latest information you need to know on mpox and HIV. This guidance will be updated regularly.

Last updated: 16 August 2024

What is mpox?

Mpox (formerly known as monkeypox) is a virus that causes illness in humans and is usually found, or endemic, in central and western Africa. Since 13 May 2022, mpox has been found in multiple countries outside the endemic areas.

On 23 July 2022, the World Health Organization (WHO) declared mpox a public health emergency of international concern as more than 18,000 cases had been identified globally.

On 14 August 2024, WHO again declared mpox a public health emergency of international concern due to a significant upsurge of mpox in the Democratic Republic of the Congo (DRC) and neighbouring countries. The emergence of a new clade of mpox, known as clade 1b, is of great concern. Clade 1b appears to have distinct genetic characteristics, potentially influencing the transmissibility of the virus and symptom severity. 

Mpox causes fever, muscle pains, headache, swollen lymph nodes and low energy with a skin rash that usually starts one to three days after the fever. Multiple skin lesions can be found on the face, palms of the hands, soles of the feet, mouth or genitals. Symptoms of mpox can last for two to four weeks. Children, pregnant women and other people who are pregnant, and people who are immunocompromised are more likely to develop more severe illness.  

Monkeypox
Source: https://www.gov.uk/

How is mpox transmitted?

  • People with mpox are most infectious when they have symptoms. The virus is transmitted through close physical contact, including kissing and hugging, as well as oral and penetrative vaginal or anal sex.
  • Pregnant people with mpox can transmit the virus to the foetus during pregnancy or to the newborn baby during and after birth. 
  • Mpox can be transmitted from wild animals through direct contact with infected animals and their fluids or waste, or during activities like hunting, trapping or processing them.
  • Skin lesions, respiratory droplets, bodily fluids and contaminated bedding or towels can all present a risk of being exposed to mpox.        

Who is most vulnerable to mpox?

Anyone, of any age or sexuality, with or without underlying health conditions, can get mpox. A person who has close contact or sexual intercourse with someone with symptoms of mpox can acquire mpox. However, children, pregnant women and other people who are pregnant, and people who are immunocompromised can be more likely to develop more severe illness. People with undiagnosed or advanced HIV may be more vulnerable to severe mpox and require more treatment and support to recover fully. 


Many of the new cases are being found in children under the age of 15, gay men and other men who have sex with men, sex workers and their clients, people in contact with infected animals, and healthcare workers. Health authorities should work closely with communities that are most affected to increase awareness of the signs and symptoms so that everyone can protect themselves and others. Mpox can affect anyone, and all responses to this outbreak should avoid stigma or blame. 

What do people living with HIV need to know about mpox?

Most people who fall ill with mpox have a mild illness and recover naturally. People with compromised immune systems may be more likely to develop severe mpox. It is important for all people living with HIV to seek medical advice if they develop symptoms or have contact with anyone with mpox.

As with other viruses, like COVID-19, staying as healthy as possible, taking antiretroviral treatment regularly to reduce viral load and avoiding close contact with people with symptoms will help reduce the chances of falling ill. If you do not know your HIV status, take an HIV test. If you test positive, then it is important to start HIV treatment as soon as possible.

What does the latest research on people living with HIV and mpox tell us?

People living with HIV with a compromised immune system might experience worse mpox outcomes, a study presented at the Conference on Retroviruses and Opportunistic Infections (CROI) 2023 shows. “This is of special concern because some of the populations most vulnerable to HIV are also greatly affected by the current mpox outbreak, deepening stigma and LGBTQ-phobia,” IAS President Beatriz Grinsztejn said.

Mpox has disproportionately affected people living with HIV who account for up to 48% of diagnoses globally.

The study, presented by IAS Governing Council member Chloe Orkin on behalf of SHARE-NET, describes clinical outcomes of 382 people living with HIV and diagnosed with mpox with CD4 counts of <350 cells/mm3, which indicate a compromised immune system. Lower CD4 cell counts were associated with higher mortality rates and a more severe clinical course.

What should I do if I have symptoms of mpox?

If you think you have symptoms of mpox, contact your healthcare provider for advice. If possible, phone the clinic before you attend so they can prepare for your appointment. Your healthcare provider will help you get a test for mpox and advise you on what steps to take to stay healthy and protect other people.

If you have symptoms, reduce close physical contact with any sexual partners, friends and family to protect them from the virus. If possible, isolate at home, including from pets, until you no longer have a rash or your lesions have dried, scabbed over and fallen off. Try to stay in an area of your home separate from other household members, such as a different room and away from shared areas. Wear a facemask and cover your skin lesions if you need to use shared rooms. If you must leave your home for medical appointments or other urgent needs, wear a facemask, cover your lesions and avoid using public transport.

Anyone with symptoms of mpox should avoid travel.

What do I do if I am in contact with someone with mpox?

If you have close contact with someone who is confirmed to have mpox, contact your healthcare provider for advice. Check for symptoms of a high temperature, swollen lymph nodes or a rash for 21 days after your last contact with the person with mpox; 21 days is thought to be how long it takes for the virus to cause symptoms. The symptoms of mpox can be similar to other viruses, so if you develop any symptoms during this time, seek medical advice so you can be tested for mpox.

How can I protect myself and others from mpox?

Avoid direct skin-to-skin or face-to-face contact, including sexual intercourse, with anyone who has symptoms. If you are in close contact with someone with symptoms, encourage them to self-isolate and seek healthcare advice. If you live with someone with symptoms, ask them to cover any skin lesions with clothing; regularly wash your hands; and wear a facemask and disposable gloves when providing physical care or handling their clothing or bedding.

Using condoms helps prevent sexually transmitted infections, including HIV. Condoms can also help reduce the chance of acquiring and transmitting mpox. WHO recommends using condoms for 12 weeks after recovery to prevent transmission of mpox to sexual partners. 

Is there a vaccine for mpox?

Three vaccines (MVA-BN, LC16, and OrthopoxVac) have been approved for the prevention of mpox. Vaccination is recommended for vulnerable people, such as close contacts of someone with mpox or those in most vulnerable groups. Mass vaccination is not currently advised. If you are vulnerable, consult your healthcare provider about available vaccine options. Vaccines, combined with other public health measures, are crucial in protecting communities.
    
Mpox vaccines offer protection against acquisition and severe disease, although it takes several weeks post-vaccination to develop immunity. Initial studies on vaccine effectiveness are promising, showing good protection against mpox. As research progresses, our understanding of the vaccines' effectiveness in different settings will grow.

The latest

Clade 1b of the mpox virus, predominantly found in western and central Africa, poses a significant health threat due to its higher transmissibility and potential for severe symptoms. As mpox continues to impact various communities, it's crucial to stay informed about prevention and treatment measures to protect yourself and others from this viral threat. 

Read more

The IAS promotes the use of non-stigmatizing, people-first language. The translations are all automated in the interest of making our content as widely accessible as possible. Regretfully, they may not always adhere to the people-first language of the original version.