Infectious diseases are a part of life. But, knowing how to respond isn’t always easy. For many gay, bisexual, and queer men—including Two-Spirit, trans, and gender diverse people (2S/GBTQ+)— outbreaks of mpox, or , have meant uncertainties: How can we protect ourselves and our communities? What steps should we take if we test positive? How can we respond to fear and stigma linked to mpox?
While anyone can get mpox, recent outbreaks are mostly impacting 2S/GBTQ+ people. The outcomes can sometimes be severe. The good news is our communities have tremendous experience rallying in response to infectious diseases and STIs. This site exists to share information about mpox—what we know, what we don’t, and how you can care for yourself and each other.
What is Mpox?
Mpox (monkeypox) is a virus that can cause fever, muscle pains, and a rash that develops into blisters. It’s no walk in the park! Mpox generally goes away on its own, but symptoms can last several weeks or more. Mpox is related to smallpox, but the symptoms are less severe.
It’s exceedingly rare to die from mpox based on what we’re seeing in recent outbreaks, but hospitalization is sometimes required. Getting mpox also means weeks of self-isolation in order to prevent the spread of the virus, and many people experience intense pain.
How is Mpox transmitted?
Mpox seems to be most commonly spread through skin-to-skin contact during sex, including oral or anal sex and rimming. It can also be passed on during other types of close physical contact or exposure to contaminated surfaces or bedding.
While mpox can be transmitted though close contact, including sex, it can also be passed on through non-sexual contact. What’s clear is that the virus is being passed on through 2S/GBTQ+ sexual networks. This means that, based on current trends, you’re much more likely to be exposed to mpox if you are sexually active and have many sexual partners.
Getting vaccinated reduces the chances of mpox infection and can prevent serious illness. Vaccines against mpox are currently available for 2S/GBTQ+ people in several provinces and territories. See our resource page for information about the vaccine and where to access it.
Communicating with partners
Communicating with your sexual partners can also help stop the spread of the virus. It may be simple, but exchanging contact information with people you sleep with can help keep each other safe. If one of you tests positive for mpox, it will be easier for your local public health authority to engage in contact tracing. This can help to identify mpox cases sooner, and enable easier access to testing, vaccination, and other kinds of support.
Taking additional steps to reduce transmission
We all navigate sex and risk in our own way. If you’re thinking of taking additional steps to reduce the spread of mpox, you have some options. For example, during the COVID-19 pandemic, some 2S/GBTQ+ people reduced their number of sexual partners, chose to sext or cam more often, or formed “sex bubbles”, limiting their sexual partners within a closed group. These strategies would also work to reduce exposure to mpox.
Because mpox can be transmitted in various ways, including through respiratory droplets, the skin, and possibly bodily fluids, barriers like masks and condoms aren’t a surefire way to prevent transmission. That said, it’s possible these barriers offer some level of protection from mpox, and—in any case—help prevent other infections.
Mpox symptoms can show up between 5 and 21 days after exposure to the virus, but most often show up between 6 and 13 days after exposure. If you think you might have mpox, review the symptoms, which can include fever, muscle pains, and a rash that develops into blisters. Many people experience fever/chills before they notice any rash. If you have symptoms consistent with mpox, contact your health-care provider or local public health authority to get tested. Limit contact with others.
When it comes to getting tested, you may want to reach out directly to a health care worker you know and trust. Not all health care workers are knowledgeable about mpox, or about issues impacting 2S/GBTQ+ people. If you’re at a loss on who to reach out to, your local public health authority should be able to connect you with local resources. You may also experience difficulty accessing testing if you don’t have pocks (sores or blisters). Although research on mpox is still evolving, recent studies suggest that some folks who acquire mpox may never develop symptoms.
Check out our resource page to learn more about self-advocacy relating to testing and other mpox supports. While mpox usually resolves on its own eventually, getting tested will confirm whether you need to isolate, and provide important information to the health care system on the spread of the virus.
If you have mpox, you aren’t alone. Infectious diseases are a part of life, but unfortunately they can also lead to feelings of shame and marginalization. As the virus continues to impact 2S/GBTQ+ communities, there is continued stigma relating to mpox and those who are getting it. Check out our resource page or visit igotmpox.com to read first-hand accounts from people who’ve experienced mpox, and advice about navigating stigma related to mpox
Vaccination—If you’ve already been exposed to mpox, getting vaccinated can still help your immune system fight the virus. Contact your health care provider or local public health authority to ask about post-exposure prophylaxis (PEP) for mpox. Getting the vaccine is recommended as soon as possible after exposure to mpox, but can be provided up to two weeks after exposure.
Isolation—Recovering from mpox requires self-isolation, which can last three weeks or longer. For many, this can be a big challenge. But wherever possible, follow isolation guidance from your public health authority. The pocks (sores or blisters), continue to be infectious until the scab falls off and there is new skin underneath.
If you are isolating, consider reaching out to your support network. If you aren’t in isolation but know someone who is, consider reaching out to them and offering to deliver supplies if you’re able.
Wound care—Effective wound care can help in managing pain and discomfort from mpox, but many people with mpox aren’t given proper guidance from the health care system. Learn more about wound care for mpox on the resource page.
Seeking medical treatment—Mpox usually resolves on its own within three to four weeks. But, for many, mpox causes significant pain and discomfort, and it may be important to receive medical attention during this time. When it comes to pain, try talking to your health care provider if over-the-counter painkillers aren’t cutting it.
If you have pocks in/near your eyes, in your throat (affecting your ability to breathe) or rectum (with intense pain), you should seek medical attention to prevent any long term damage.
In addition to getting tested for mpox, it is important to seek medical care if there are signs of a secondary bacterial infection. It’s possible for pocks (sores or blisters) caused by mpox anywhere on your body to get infected. Avoid scratching the area to reduce the chance of infection. Some signs that your pocks are infected include extra redness in the surrounding area, swelling, and increasing or intense pain, white discharge, and having a fever.
Tecovirimat (also known as Tpoxx) is an antiviral drug designed to treat smallpox. In some contexts, tecovirimat is also being prescribed to treat mpox, however this form of treatment is considered “off-label” and there isn’t strong evidence to support it at this stage.
Typically, Tpoxx is only prescribed for those who have very severe symptoms or who need hospitalization. More research will help determine whether tecovirimat is an appropriate treatment for mpox more generally.
For people living with HIV, current guidance doesn’t indicate additional measures necessary to prevent mpox infection. However, all people who are immunocompromised—including those living with HIV who are not receiving regular antiretroviral treatment or have a CD4 below 200—may have a higher likelihood of severe illness if they are exposed to mpox. The vaccine currently offered in Canada (Imvamune) is shown to be safe for people living with HIV.
Research is ongoing to understand trends in recent mpox transmission. While it’s clear mpox is spreading within 2S/GBTQ+ men’s social and sexual networks, the reason 2S/GBTQ+ people are most impacted is less clear.
One explanation is that 2S/GBTQ+ people tend to have different sexual patterns than other groups. 2S/GBTQ+ people often have a higher number of sexual partners, for example, and non-monogamous relationships are more common. This may mean the mpox virus can spread more easily in a “chain” from person to person. While many non-2S/GBTQ+ people also have a high number of sexual partners, different patterns of sex and intimacy in the population could mean the virus doesn’t spread efficiently enough to survive. This aligns with one mpox modelling study from the UK, which used data about sexual patterns to predict mpox transmission.
Still, we don’t know which groups of 2S/GBT2Q+ people are most impacted in Canada. Data from US public health authorities have identified significant barriers to vaccine access for Black and Latinx communities; yet, Black and Latinx folks make up a disproportionate share of Mpox cases in the US. These trends are likely similar in Canada for marginalized communities such as Two-Spirit, Black and Indigenous people, and people of colour. Public health agencies in Canada are not currently publishing race-based data, meaning racial inequities are more difficult to identify and address.
We invited several folks who contracted mpox to share their story, in the hopes of reducing stigma and providing much-needed firsthand information for our communities. We know not enough is being done to support people with mpox and we commend these folks for their bravery in choosing to share their experiences publicly.