Mpox (hMPXV): what gay, queer and trans folks and other people at high risk should know

How to prevent and treat mpox and where to get tested.

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Updated January 11, 2023

In the current mpox outbreak, most, but not all, cases are among men who have sex with men.

If someone in your social group has mpox, you are at higher risk. Public health recommends you

  • Get vaccinated. Call 503-988-4724 to find a vaccine near you.
  • Avoid prolonged skin-to-skin contact with others if you or your sexual partner(s) have a rash.
  • Watch for symptoms.
  • Get tested if you have symptoms.
  • Get vaccinated within 14 days if you have been exposed.

Since learning that mpox was in Multnomah County, we have come together to slow the spread of this disease. Community members have encouraged each other to get vaccinated and communicate about safety, risk, and exposures. These actions have led to fewer mpox cases in our area. Thank you for stepping up!

Some mpox remains in the community, so we must continue to work together until it is gone. Vaccines are still important and are more widely available than ever.

Avoid prolonged skin-to-skin contact

Mpox usually spreads by having close, direct contact with skin that has rashes or sores. In the current outbreak most (but not all) spread has occurred during sex or other intimate contact. Sores can be anywhere on the body, including hands, face, genital area, around the anus or butt, and in the mouth.

If you have sex with a new partner or partners:

  • Have sex in a well-lit place where you can see if someone has a rash on the part of their body that will be in contact with yours.
  • Talk openly about whether they have felt sick or noticed new bumps or a rash recently. This is not a “sexy” conversation, for sure, but this is a way to stop transmission.
  • Keep up-to-date contact information for partners so you can reach them if you test positive for mpox. They may be able to get a preventive vaccine.

If the suggestions above won’t work, consider decreasing or taking a break from back room sex and sex club sex until the virus is no longer spreading locally.

  • Consider “keeping your shirt on” at clubs.
  • Don’t share towels or clothes at the gym, beach, etc.
  • Sometimes an individual with infection only has sores on their penis or in their rectum/vagina. In those cases, using condoms may reduce risk of transmission. The best prevention is to avoid intimate/sexual contact until the sores are completely gone, but some people who have sores only in their rectum or mouth may not know they are there.

Watch carefully for rash or sores

  • If you start to feel sick with a fever, headache, chills, weakness, fatigue, or swollen lymph nodes.
  • If you have been in close contact with someone:
    • Diagnosed with mpox
    • Waiting on test results for mpox
    • With symptoms of mpox
  • If you have been at an event or venue and had:
    • Skin-to-skin contact with others. Remember: skin to skin is NOT only genital area contact–the rash can be on hands and other parts of the body, so things like holding hands with someone who has the rash on their hands, dancing with skin touching, cuddling, or massage can transmit it.
    • Contact with used towels, sheets, clothing or surfaces that others may have used or touched.

Watch for signs of infection if, in the last 14 days, you have had multiple or anonymous sex partners.

If you might have been exposed to mpox (hMPXV) (OHA)

How to identify the rash, bumps or sores

Check your body regularly, such as before or after bathing. Look at your whole body in good lighting. Use a mirror to look at your back. Pay attention to anything that looks like a new bug bite, pimple, ingrown hair, or rash. Here are pictures of typical rash/sores. Check

  • Chest
  • Belly
  • Armpits
  • Back
  • Feet
  • Hands
  • Face
  • Neck.

Use a hand mirror and flashlight or desk lamp, or have a partner, friend or housemate help look around the anus and genital area. Shine the light into the mirror instead of directly on the skin. It’s easier to aim, less glare.

Sores can be itchy or very painful, and can be flat or raised, fluid-filled (like little blisters or large pimples) or not. Classic sores have an indent in the middle, but not everyone will develop a classic rash.

If the sores you have are in your throat or rectum, they may cause significant pain but not be visible.

If you see a rash or have other symptoms

  • Isolate from others and get tested. Stay isolated until your results are back and are negative.
  • Stay at home except to seek medical care.
  • If you live with others, wear a mask in common spaces.
  • Use a separate bathroom if possible and if not, clean it frequently with a germicidal wipe, and prevent others from touching your bedding, towels, clothes, etc.
  • Going outside for recreation is safe and encouraged, but avoid contact with others, especially in indoor spaces, public transportation, or anywhere else your skin may come in contact with surfaces others may touch.

Testing

Request testing from your healthcare provider. If you can’t find testing or don’t have a provider, call 211 for help.

More support

We recognize that learning of a new disease spreading in a specific community - especially one that has experienced and continues to experience stigma - can be upsetting and traumatizing.

If you need support, anyone can call the Multnomah County Behavioral Health Call Center at 503-988-4888 or 800-716-9769. Open any time of day or night. Services are free. Interpretation available for non-English speakers.

Learn more

Last reviewed November 27, 2024