The 2022 monkeypox outbreak has been associated with intimate, close personal contact, including kissing and touching. In previous outbreaks, household contacts have also been infected. Knowing what to look for and how to prevent passing the infection on can help keep your friends and family healthy.
The current global monkeypox outbreak is marked by a very strong correlation with intimate contact. In the reported cases, health officials are seeing a few common risk factors, including:
- Transmission via sexual contact, including kissing, touching, and any bodily fluid exchange.
- Widespread cases in areas where the virus is not endemic (doesn't normally exist in nature).
- No association with infected animals as with a previous outbreak involving imported prairie dogs.
Monkeypox and sexual transmission
Monkeypox can cause mild to more severe symptoms, depending on the individual. Transmission can occur with close contact, contact with contaminated items, like bedding, forks, spoons, or clothing, and sexual activity.
How long symptoms last also varies, taking two to four weeks to fully resolve. It is uncertain at the moment how infectious semen (seminal fluid) is, how efficiently monkeypox can transmit in saliva, or among people who have no fever or other signs of illness except for a few bumps. In fact, a recent study, which collected reports from 16 countries, found that nearly two-thirds of cases had fewer than 10 lesions.
In previous outbreaks, fatality was 3 to 6% but data is still being collected on the current global outbreak. Fatality rates may be lower due to differences in testing, access to care, the availability of vaccines, and underlying health status.
Although the fatality rate appears to be low, the illness is very uncomfortable and highly infectious through close contact. If your partner has monkeypox, it is important to abstain from intimate contact until the lesions are healed and new skin has grown over the affected areas. But, how long do you have to give up sex?
When will sex be safe?
You’ve had monkeypox, your lesions are resolving, and you are eager to be with your partner again. When will sex be safe? Currently, scientists aren't 100% sure. Because the disease can last up to four weeks, sexual contact should be avoided at least until new skin has grown over the sores.
Remember that you can spread it by close contact, bodily fluids, droplets from your respiratory tract, or the sores. Additionally, household surfaces like bedding and doorknobs can carry the virus and cause infection. So, the best prevention is avoiding exposure by withholding from sexual activity until fully healed and taking everyday hygiene precautions. This means no vaginal, oral, or anal sex and no kissing, touching, or fondling while feeling sick and with active open sores.
Even once monkeypox has resolved, scientists are not yet clear on how long sexual activity could pose a risk. Therefore, some countries have recommended using a condom for eight to 12 weeks after skin sores heal.
Other ways to keep loved ones safe
If you avoid close contact, including sexual interactions, additional steps further help protect your friends and family. Don't share toothbrushes, sex toys, or other objects that could easily carry the virus. Sleep in separate beds from your sexual partner until symptoms have fully resolved, and always remember everyday hygiene such as hand washing.
Minimizing risk while remaining sexually active
While abstinence or having a monogamous (with only one partner at a time) relationship can help reduce risk, some people may choose to continue with sexual activity, knowing the risks. Suppose you participate in sexual contact when you or a partner has been exposed or shows signs of disease, you can still take a few steps to protect yourself and your partner(s).
- Consider virtual, contact-less sex.
- Only one partner.
- Limit sex with new partners.
- Consider contactless masturbation while maintaining a six-foot minimum distance.
- If any new encounters occur, make sure to always share contact information with that person to allow follow-up if signs develop.
- Provide a barrier between you and any sores – clothing, latex, doors.
- Avoid kissing and other exchanges of body fluids.
- Practice proper hygiene.
- Avoid visitors and self-isolate at home until your skin heals, and no further rashes develop.
- Avoid sharing dishes, preparing meals for others, or sharing utensils.
- Monitor yourself and any partners for changes in how you feel, including new signs of skin sores or rashes.
- If you develop symptoms, inform anyone you had contact with that may be at risk.
- It is also unknown if condoms help prevent transmission, and not all areas of the body can be covered by a condom. Although using condoms may help for vaginal or anal sex, abstinence remains the best practice when ill because face-to-face contact can still cause infections to spread.
- Cover skin lesions if you are in direct contact with someone to lessen the chance of transmission.
- Consider avoiding large social gatherings, especially where skin-to-skin contact is likely.
Practice proper hygiene
Regardless of whether you elect to continue to engage in sexual activity or practice abstinence, always practice proper hygiene.
Furthermore, suppose you had contact with another person before or once signs developed. Given that, you should have those people monitor themselves for 21 days after their last exposure with you. They should avoid contact with anyone at an increased risk of infection, such as children or those who are immunocompromised. If symptoms develop, then isolation is recommended. Talk to your physician about the timing of vaccination and if it is available to you.
The best way to keep friends and family safe while engaging in sexual activity is to be smart. Think about your actions and the consequences. Practicing safe sex, avoiding large groups and parties where clothes are optional, engaging in activities with one or only known partners, and abstaining from sexual activity if signs of monkeypox develop help to ensure you and your friends and family stay safe and healthy.
Abstinence prevents sexual transmission of monkeypox.
Avoid sexual contact at a minimum until any sores fully resolve, and you feel well.
Avoid large gatherings and close skin-to-skin contact.
If engaging in sexual activity, take steps to protect your friends and partners.
The World Health Organization. Monkeypox.
NJ Health, New Jersey Department of Health. Monkeypox FAQ.
The Cleveland Clinic. Why Safe Sex is Important During a Monkeypox Outbreak.
Centers for Disease Control & Prevention. Clinician FAQs.
IndeVets. Monkeypox: A serious One Health threat or barely a blip on the radar?.
Children's Hospital of Philadelphia (CHOP). News & Views – Monkeypox: What You Should Know.
Centers for Disease Control & Prevention. How to Protect Yourself. Monkeypox Prevention Steps.