Monkeypox disproportionally affecting people with HIV

Artistic representation of the monkeypox virus. Image by Samuel F. Johanns from Pixabay

A new study from the Centers for Disease Control and Prevention (CDC) has found that people with HIV have been hit especially hard by monkeypox.

Researchers found the impact by looking out incidents of eight state, county and city jurisdictions: California (including Los Angeles County and San Francisco), District of Columbia, Georgia, Illinois (including Chicago), and New York (excluding New York City).

Among 1,969 persons older than 18 with monkeypox diagnosed during May 17–July 22, 38% had received an HIV diagnosis, 41% had another reportable STI diagnosed in the preceding year, and 363 (18%) had both; 1,208 (61%) persons had either (Table 1) (Table 2).*** People with monkeypox and HIV infection more commonly had received an STI diagnosis in the preceding year (48%) than had those without HIV infection (37%).

The CDC also said that people with HIV were more likely to experience symptoms like rectal pain, rectal bleeding, purulent or bloody stools, and anal sensitivity than those without HIV. They were less likely to have swelling lymph nodes.

The percentage of people with monkeypox who had HIV infection was higher in older age groups: among persons aged 18–24 years, HIV prevalence was 21%, and among those older than 55, it was 59%. HIV prevalence among persons with monkeypox also varied by race and ethnicity, ranging from a high of 63% among non-Hispanic Black people , to 41% among Latino people, 28% among non-Hispanic White people, and 22% among non-Hispanic Asian people.

The CDC is suggesting that vaccination efforts should focus on people with HIV and STIs for vaccination and other prevention efforts. HIV and STI screening and other recommended preventive care should be routinely offered to persons evaluated for monkeypox, with linkage to HIV care or PrEP.

The agency also said that the fact so many with monkeypox diagnoses among people with recent access to HIV and sexual health services may be skewing the numbers. They’re people who are already being proactive in sexual health and more likely to identify new infections.