2025 Updated Costs and Insights: Monkeypox (Mpox) and HIV - Risk Factors, Treatment, and Prevention

Living with HIV, especially if undiagnosed or untreated, can weaken your immune defenses, making you more vulnerable to infections such as monkeypox, now officially called mpox. It’s important to understand that while HIV and mpox are caused by different viruses, their interaction can impact health outcomes significantly.

HIV gradually diminishes immune function by targeting CD4 cells, critical components of your immune system. When untreated, this reduction increases the risk of opportunistic infections like mpox.

Mpox is a viral illness related to smallpox, characterized by symptoms such as fever, rash resembling lesions, and swollen lymph nodes.

Though mpox and HIV are distinct viruses, research shows a notable overlap in infections among people living with HIV, especially those with advanced immune suppression.

Note: The World Health Organization renamed 'monkeypox' to 'mpox' in late 2022 to remove stigmatizing and racist connotations associated with the original name.

What Does Research Reveal About Mpox and HIV in 2024?

Anyone can contract mpox, but individuals with untreated or advanced HIV face higher susceptibility. Data from the CDC between May and July 2022 indicated that out of 1,969 mpox cases, 755 had a prior HIV diagnosis, with the percentage of co-infections rising steadily.

Experts emphasize that people with well-managed HIV and strong CD4 counts do not face increased severe mpox risk compared to HIV-negative individuals. However, those with CD4 counts below 350 cells/mm³ are at significantly higher risk of severe mpox complications and mortality.

CD4 cells, also known as T cells, are vital white blood cells that help fight infections. HIV damages these cells, compromising immunity and increasing vulnerability to viruses like mpox.

Understanding Mpox Transmission and Risk Groups

The mpox virus (MPXV) primarily spreads through direct skin-to-skin contact with infectious rash, scabs, or bodily fluids. Close physical contact, including sexual activity, can facilitate transmission, but mpox is not classified as a sexually transmitted infection.

Transmission can also occur via respiratory droplets through face-to-face interactions, such as talking, coughing, or sneezing.

Immunocompromised individuals, including many living with HIV, are especially at risk, highlighting the importance of vaccination and exposure reduction.

Effective Prevention Strategies Against Mpox

Vaccination remains the most effective way to reduce mpox risk. The mpox vaccine requires two doses spaced four weeks apart for optimal protection.

Additional preventive measures include frequent handwashing, avoiding contact with contaminated surfaces or materials, and steering clear of animals known to carry mpox, especially rodents.

For people living with HIV, maintaining consistent antiretroviral therapy (ART) to manage HIV and improve CD4 counts is crucial in lowering mpox risk.

When to Seek Medical Advice

If you suspect exposure to mpox or experience symptoms like fever, rash, or swollen lymph nodes, promptly consult a healthcare professional. Early diagnosis and treatment can alleviate pain and prevent complications.

Clinicians diagnose mpox by swabbing lesions or rashes for laboratory testing, as blood, urine, or genital swabs are not reliable for mpox detection.

Current Treatment Options for Mpox

Most mpox cases resolve naturally within 3 to 6 weeks. However, antiviral medications and pain management therapies are available for moderate to severe cases.

Those with advanced HIV may receive additional antiviral treatments to reduce the risk of severe disease and mortality, aiming to support immune recovery and viral clearance.

Summary

Individuals with compromised immune systems, particularly those with undiagnosed or untreated HIV, face increased vulnerability to mpox. Regular HIV testing and adherence to treatment plans are essential to strengthen immunity.

Vaccination and preventive behaviors play a key role in reducing mpox risk. Always consult healthcare professionals for personalized advice and timely care.

Gabrielle Kassel (she/her) is a dedicated queer sex educator and wellness journalist passionate about empowering individuals to optimize their health. Her work appears in leading health publications, and she enjoys coaching CrossFit, outdoor adventures, and podcasting in her free time. Follow her on Instagram @Gabriellekassel.

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