While anyone can contract monkeypox through close personal contact, most people affected by the outbreak in non-endemic countries are gay, bisexual and other men who have sex with men. It is not known whether monkeypox is sexually transmitted in semen or vaginal fluid, but it can spread via contact with sores during sex.
It also can be transmitted through respiratory droplets at close range, but it does not spread over longer distances like the coronavirus that causes COVID-19. This can include skin-to-skin contact, kissing and contact with contaminated clothing or bed linens. The monkeypox virus is transmitted from animals and from person to person through close contact. The United Kingdom, Spain, Portugal, Germany and Canada have reported the most cases outside Africa. Worldwide, the World Health Organization (WHO) has confirmed 1,285 cases in more than two dozen countries where the virus is not endemic as of June 10. In the United States, the Centers for Disease Control and Prevention (CDC) has reported 72 confirmed cases of monkeypox in 17 states and Washington, DC, as of June 14, including 15 cases each in California and New York.
So far, it appears that people on antiretroviral treatment with well-controlled HIV do not have worse outcomes. As monkeypox continues to spread in Europe and North America, mostly among gay and bisexual men, much remains to be learned about its impact on people living with or at risk for HIV.
