A new report from the Centers for Disease Control and Prevention finds that a disproportionate number of people who are contracting monkeypox in the U.S. are also HIV-positive.


U.S. health officials are hopeful that the monkeypox outbreak is now slowing. But they have noticed a puzzling trend. A large proportion of monkeypox cases have occurred in people with HIV. Here’s NPR’s Pien Huang.

PIEN HUANG, BYLINE: In the U.S., around 20% of men who have sex with men are thought to be living with HIV. But when you look at monkeypox cases, almost 40% are found among people with HIV. That’s from a study released yesterday by the CDC looking at almost 2,000 cases from the first two months of the outbreak. Dr. John T. Brooks co-authored the CDC paper. He says it’s true that the rate of HIV among gay, queer and other men who have sex with men is much higher than the general population.

JOHN T BROOKS: But even above and beyond that, this fraction of HIV is pretty extraordinary.

HUANG: Brooks says the most likely cause seems to be behavior.

BROOKS: The things that put you at risk for monkeypox also put you at risk for sexually transmitted infections, also puts you at risk for HIV. So if you have one, think of the others.

HUANG: Monkeypox is spread through close, sustained physical contact. Right now, the CDC says it’s spreading almost exclusively through sexual contact. The study also found that those with monkeypox and HIV tend to be older, like 55 and up, or Black or Latino. Dr. Boghuma Titanji is an infectious disease specialist at Emory University who’s not affiliated with the study. And it may not only be behavior, she says. It’s an open question whether biology might also play a role.

BOGHUMA TITANJI: Whether the fact that someone might be living with HIV affects their biological risk for acquiring monkeypox infection if they encounter the virus through a high-risk exposure.

HUANG: It’s also possible that the data is a little skewed. People with HIV might be testing positive for monkeypox more often because they tend to get regular medical care with doctors who know to look for it. Dr. Demetre Daskalakis, who’s helping lead the White House monkeypox response, says they’re taking action.

DEMETRE DASKALAKIS: From the beginning of the vaccination effort, there was guidance that because of the short of supply of vaccine that folks living with HIV should be prioritized for vaccine. But now, rather than looking for it, it’s coming to them because there’s more supply.

HUANG: Daskalakis says they’re sending vaccines into clinics that specialize in treating people with HIV and, after Pride events, where the community gathers.

Pien Huang, NPR News.


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