How do monkeypox, HIV, and sexually transmitted infections appear together in patients?
Monkeypox, HIV, and other sexually transmitted infections (STIs) frequently coexist in patients, particularly within the men who have sex with men (MSM) community. Research shows that having HIV or other STIs makes a person much more likely to get monkeypox. Additionally, people living with HIV who have weaker immune systems face worse outcomes if they contract monkeypox.
What the research says
Studies from China found that among men who have sex with men, having HIV alone increased the risk of monkeypox by about 2 times, while having other STIs alone increased the risk by over 6 times. Those with both HIV and other STIs faced the highest risk, with odds nearly 9 times higher than those with neither condition 6.
Data from the United States confirms that HIV and other STIs are common coinfections in people with monkeypox. In one report, a significant portion of patients with monkeypox were also living with HIV or had other STIs, highlighting how these infections cluster together 4.
The presence of HIV affects the severity of monkeypox. A global study noted that people living with HIV made up a large share of monkeypox cases. Those with advanced HIV, defined by low CD4 cell counts, experienced worse clinical outcomes and higher mortality rates compared to people without HIV or with stronger immune systems 5.
Another study of 65 patients with monkeypox in Paris found that sexual transmission was the primary route of infection for most cases. Among those who had monkeypox, a large percentage were living with HIV, and many were taking pre-exposure prophylaxis (PrEP) for HIV prevention 7.
What to ask your doctor
- How does my current HIV status or other STIs affect my risk of getting monkeypox?
- What are the signs of monkeypox I should watch for if I have HIV?
- Does taking HIV pre-exposure prophylaxis (PrEP) reduce my risk of monkeypox?
- What testing do I need if I have symptoms that could be monkeypox, HIV, or another STI?
- How can I protect my sexual partners if I have monkeypox or HIV?
This question is drawn from common patient questions about Infectious Disease and answered using cited medical research. We do not provide individualized advice.