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Monkeypox: things to know if you have HIV

Hester Phillips

15 August 2022

Here are the facts on monkeypox – and what it means if you have HIV.

The most important thing is to take your HIV treatment properly to keep your immune system strong.

A person taking a pill
Photos are used for illustrative purposes. They do not imply health status or behaviour. Credit: iStock/ljubaphoto

A global outbreak of monkeypox in more than 70 countries has led the World Health Organization (WHO) to declare an international public health emergency. So what does this mean for you?

What is monkeypox?

Monkeypox is caused by a virus that began in wild animals. It is related to smallpox but is less severe. It can take three weeks after getting monkeypox to get ill. The symptoms usually last two to four weeks.

Monkeypox is not new. It has been mainly found in Central and West Africa before. But outbreaks there have not spread as easily as this one.

Is monkeypox dangerous?

No. Monkeypox is usually mild. It causes symptoms like the flu, such as fever, headaches, muscle aches, swollen glands and exhaustion. It can also cause a rash. This starts as small, red bumps then turns into ulcers or blisters. This can appear anywhere on the body, including on the face, inside the mouth and around the genitals and anus.

In more severe cases, monkeypox can cause serious secondary infections. These include bronchopneumonia, sepsis, encephalitis and cornea infections (which can cause sight loss). Although deaths from monkeypox are rare, they can happen.

How is monkeypox spread?

Monkeypox is passed on through close contact with skin, bodily fluids or surfaces that contain the virus.

This means it is passed on through skin-to-skin contact, kissing, and touching things like clothing or bedding. monkeypox spots, ulcers and blisters are most likely to spread the virus.

The monkeypox virus can also spread through droplets from the nose or mouth. These get in the air when people do things like sneeze or cough. But these droplets only pass on the virus at close range.

Monkeypox is not a sexually transmitted infection (STI). But it is passed on through close contact, which is a big part of sex.

This global outbreak appears to be spreading through sexual networks, mainly involving gay men and other men who have sex with men. But monkeypox can infect anyone.

Am I more at risk from monkeypox if I have HIV?

People with immune deficiencies (when your immune system cannot fight infections well) are more at risk of getting seriously ill from monkeypox.

If you have HIV and are not on antiretroviral treatment (ART) you are much more likely to have a poor immune system. And this makes you more at risk of getting seriously ill from monkeypox.

What can I do to protect myself from monkeypox if I have HIV?

The most important thing is to take ART and take it properly. This means taking it every day.

There is not much evidence on monkeypox and HIV. But what we know so far is that people on ART who are virally suppressed are at no more risk of getting seriously ill from monkeypox than people without HIV. Being virally suppressed means the level of HIV in your body is very low. This protects your immune system so you’re less likely to get sick. 

Monkeypox spots, ulcers and blisters can appear on any part of the body, so condoms will not necessarily prevent the monkeypox virus being passed on during sex. But it is still a good idea to use condoms, as they might give some protection if the rash is on the genitals or anus.

If someone has monkeypox symptoms you should avoid close contact with them and not share things like bedding and towels. If you touch skin that has a rash, ulcers or blisters you should regularly wash or sanitise your hands.

There is a vaccination for smallpox, which also works for monkeypox. But at the moment it is only available in a few high-income countries.

What should I do if I have monkeypox?

Contact a healthcare professional if you have monkeypox symptoms or have been in close contact with someone who does. They can arrange for you to get tested.

You should try to avoid close contact with other people until you are fully recovered and your rash has gone. Don’t share bedding or towels. And be sure to wash your hands lots.

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