The Centers for Disease Control and Prevention (CDC) has created a variety of resources related to the ongoing MPV outbreak in the United States. These include a fact sheet (PDF, 118 KB), guidance for social gatherings, health tips for gay and bisexual men, and information to reduce stigma. People with advanced HIV infection or who are not taking antiretroviral drugs might be at increased risk for severe disease if they get monkeypox. Monkeypox can be treated with the antiviral drug tecovirimat (TPOXX). Please visit CDC’s FAQs on Monkeypox and HIV.
What You Need to Know
- CDC is tracking an outbreak of monkeypox that has spread across several countries that don’t normally report monkeypox, including the United States.
- The monkeypox virus is spreading mostly through close, intimate contact with someone who has monkeypox.
- You can take steps to prevent getting monkeypox and lower your risk during sex.
- CDC recommends vaccination for people who have been exposed to monkeypox and people who are at higher risk of being exposed to monkeypox.
- If you have any symptoms of monkeypox, talk to your healthcare provider, even if you don’t think you had contact with someone who has monkeypox.
- CDC is urging healthcare providers in the United States to be alert for patients who have rash illnesses consistent with monkeypox.
Federal Resources: Monkeypox and HIV
- Clinicalinfo.HIV.gov — Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV, Monkeypox Update
- HRSA Ryan White HIV/AIDS Program — Monkeypox Resources
Monkeypox and HIV FAQs
Are people with HIV more likely to get monkeypox?
People with advanced HIV infection or who are not taking antiretroviral drugs might be at increased risk for severe disease if they get monkeypox. Monkeypox can be treated with the antiviral drug tecovirimat (TPOXX). Monkeypox can spread to anyone through prolonged, close, personal, often skin-to-skin contact, as well as through contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox, or contact with respiratory secretions, through kissing and other face-to-face contact.
Are people with HIV more likely to have more severe illness if they get monkeypox?
CDC continues to monitor monkeypox among people with HIV. During the current monkeypox outbreak, there does not appear to be more severe monkeypox illness in people who have HIV and are virally suppressed (having less than 200 copies of HIV per milliliter of blood). In fact, the World Health Organization (WHO) monkeypox guidance states, “People living with HIV on antiretroviral therapy with suppressed viral load are not considered to be immunosuppressed.” However, people with HIV who are not virally suppressed may be at increased risk for severe illness and death from monkeypox.
What treatment is recommended for people with HIV who get monkeypox?
Currently there is no treatment approved specifically for monkeypox. However, medicine (antivirals) developed for use in patients with smallpox may help treat people with monkeypox.
At this time, CDC doesn’t have enough data to know whether people who have HIV and are virally suppressed might benefit from taking medicine if they get monkeypox.
Because patients with a weakened immune system may have more severe monkeypox illness, healthcare providers might consider using antiviral medicines (e.g., tecovirimat) or Vaccinia Immune Globulin for these patients. This could include people newly diagnosed with HIV or people with HIV who are not virally suppressed. See: Treatment Information for Healthcare Professionals.
Is a vaccine recommended and are vaccines safe for people with HIV?
At this time, vaccination is recommended for people with exposures to a probable or confirmed case with monkeypox, for example people who have had close physical contact with someone diagnosed with monkeypox. Vaccination may also be offered to people who had a presumed exposure, such as men who have sex with men who have had multiple sexual partners during the past 14 days in a jurisdiction with known monkeypox activity.
There are currently two licensed vaccines in the United States to prevent smallpox – JYNNEOS and ACAM2000. These smallpox vaccines may provide protection against monkeypox because smallpox and monkeypox are very similar viruses. Only JYNNEOS is FDA approved for the prevention of monkeypox in people 18 and older.
The JYNNEOS vaccine has been studied in people with HIV who are virally suppressed, and they do not have more frequent or severe side effects from the vaccine than people who did not have HIV. The JYNNEOS vaccine seems to be well tolerated, with the most common side effects being injection site pain, redness, swelling and itching. Some recipients also reported muscle pain, headache, fatigue, nausea, and chills. More data are needed to know if this vaccine is tolerated by people newly diagnosed with HIV or by people with HIV who are not virally suppressed. Clinicians should weigh the benefits of vaccination with the unknown risk of an adverse event for a person if their HIV is not virally suppressed.
ACAM2000 has been shown to have more frequent and severe side effects, especially for people with weakened immune systems or who are pregnant, have a heart condition, or skin conditions like eczema, psoriasis, or dermatitis. ACAM2000 is not recommended for people with HIV, even if they are virally suppressed, due to this increased risk of severe side effects.
Will monkeypox treatment or vaccines interact with HIV medications?
Data is limited, but most HIV treatment can be safely given with monkeypox treatment and smallpox vaccines. People with HIV should inform their healthcare provider of all their medications to help determine if any interactions exist.
Does monkeypox affect how well pre-exposure prophylaxis (PrEP) works for HIV prevention?
No, HIV pre-exposure prophylaxis (PrEP) is still effective and should be continued as prescribed.
What can people with HIV do to protect themselves from monkeypox?
People with HIV should follow the same recommendations as everyone else to protect themselves from monkeypox.
- Avoid direct contact with rashes, sores, or scabs on a person with monkeypox, including during intimate contact such as sex. We believe this is currently the most common way that monkeypox is spreading in the U.S.
- Avoid contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
- Avoid contact with respiratory secretions, through kissing and other face-to-face contact from a person with monkeypox.
For more information, including guidance around sex visit Monkeypox Facts for People Who are Sexually Active | Monkeypox | Poxvirus | CDC