Monkeypox: Safer Socializing and Sex
Monkeypox is a disease caused by the monkeypox virus. Since May 2022, outbreaks of monkeypox have been found in countries where it has not previously been seen.
How can the monkeypox virus be transmitted?
Monkeypox is spread through close contact with:
- Monkeypox sores and blisters, skin or mucous membranes (e.g. mouth, genitals).
- Items like bedding or towels that have the virus on them.
- Respiratory droplets during prolonged and/or close contact such as kissing.
Illness with monkeypox may start with flu-like symptoms, followed 1-5 days later by sores / blisters anywhere on the skin or mucous membranes. It can take up to 21 days to develop symptoms of monkeypox after being exposed to the virus.
Some people may have sores / blisters first or as their only symptom. Monkeypox sores/blisters are most commonly seen on the genitals, hands, feet, arms, legs, and/or mouth. Some people may have a small number of sores on one or a few body parts, sometimes only in the mouth or genital area. For some people, these sores can be quite painful. If sores/blisters are in the rectum, symptoms may include rectal pain, bloody stools, or diarrhea.
Symptoms can last for 2-4 weeks. A person with monkeypox can spread the virus to others while they have symptoms and until all of the scabs on their skin have fallen off and new skin has formed.
Due to how monkeypox is passed between people, communities with active sexual networks such as gay, bisexual and other men that have sex with men have been impacted more by monkeypox. Most cases in the recent outbreak have been acquired through close, intimate contact during sex. Monkeypox infection may be passed during sex through:
- Anal, genital and oral sex, and/or by touching (e.g., fingering).
- Other types of close contact during sex, including hugging, massage and kissing or making out.
- Having contact with bedding, clothing or other items (e.g., towels, sex toys) that have been used by someone with monkeypox.
Get Vaccinated:
A vaccine that prevents infection or makes the illness less severe is available for individuals at higher chance of monkeypox infection. As BC’s monkeypox outbreak is happening mainly among gay, bisexual and other men who have sex with men, vaccination efforts are focused on this population. Monkeypox vaccination is the best way to protect you and your partners from monkeypox. Please see the BCCDC monkeypox page for details about accessing first and second doses of the vaccine, and get the vaccine if you are eligible.
No vaccine is 100% effective and itt is still possible to get monkeypox after being vaccinated, particularly in the first few weeks after vaccination. If you develop symptoms of monkeypox after vaccination, see a health care provider.
Safer sex tips to prevent monkeypox
- Be aware of monkeypox symptoms and how it is transmitted.
- Talk to your partner(s) about any recent illnesses or unexplained skin rashes or sores, including on the genitals and anus, and whether they have been vaccinated.
- The spots, ulcers and blisters, which are most likely to pass on monkeypox can appear on any part of the body, so condoms will not necessarily prevent transmission of the virus. In theory, condoms may provide some protection from being exposed to monkeypox if lesions are present on the area of the penis covered by a condom, or from lesions that are inside the anus or vagina. Similarly gloves in theory may provide protection if inserting fingers or hands into the vagina or anus.
- Reduce skin-to-skin contact during sex. Having sex with your clothes on, or using leather or latex gear provides a barrier to skin-to-skin contact. Be sure to change or clean clothes/gear between partners and after use.
If you or your partner(s) have (or think you may have) monkeypox, you should abstain from sex until your skin has healed. If you do have sex, there are some strategies that may help reduce the chances of passing on monkeypox to others during sex:
- Masturbate or have virtual sex with no in-person contact.
- Avoid kissing.
- Keep any sores or blisters covered.
- Do not share clothing, towels or sex toys. Wash these items after sex.
- Limit the number of partners you have during this time.
- Wash your hands before and after any contact.
Can monkeypox be transmitted through sperm or genital secretions?
It is not clear at this time if monkeypox can be transmitted through sperm or genital fluids. Some studies have detected monkeypox virus in sperm, but it is not known if this leads to the transmission of monkeypox to other people. As a precaution some countries have advised that people diagnosed with Monkeypox should use condoms during sex for several months after their diagnosis, although there is no evidence at this time to support this recommendation.
What should I do if I develop a rash, sores or other symptoms that may be monkeypox?
Get checked by a healthcare provider. Contact the clinic before you visit and tell them that you think you might have monkeypox.
Until you see a doctor or nurse, protect others around you with these steps:
- Wear a mask.
- Do not share towels, clothing, sheets or other things that have touched your skin.
- Avoid close, prolonged skin-to-skin contact with others.
- Clean your hands, objects and surfaces that you touch regularly.
- Keep any sores or blisters covered as much as possible (e.g. wear long sleeves and pants).
Considerations for attending events and while socializing
Bathhouses, saunas, backrooms, kink and fetish parties where sexual contact is likely have a higher chance of spreading monkeypox. Raves, parties and clubs where people wear minimal clothing and there is a lot of skin-to-skin contact may also be places where monkeypox can be transmitted.
Recommendations for event organizers and community organizations are included in this guideline document developed by the BCCDC.
Travel and monkeypox awareness
When travelling, be aware monkeypox in the places you visit and take the same precautions you would use at home. Some people have been exposed or got monkeypox while travelling from close, intimate contact during sex.
Domestic travel
- The Public Health Agency of Canada has information about the monkeypox outbreak in provinces and territories in Canada.
International travel
- The Government of Canada provides advice to travellers about Monkeypox.
- The Centres for Disease Control maintains a map of the global monkeypox outbreak.
For more information
- BC Centre for Disease Control – Visit bccdc.ca/monkeypox for the most recent updates, as well as vaccination information and appointments. Information on monkeypox is changing as we learn more.
- BCCDC and Vancouver Coastal Health – Information Sheet for Two-Spirit, Gay, Bisexual, Transgender and Queer (2SGBTQ+) Communities
- Health Initiative for Men – MPox Bulletin
Adapted from: https://www.cdc.gov/poxvirus/monkeypox/sexualhealth/social.html