HIV can weaken your immune system, making you more susceptible to other illnesses, including mpox. However, neither condition causes the other. Mpox and HIV are two distinct viruses caused by two different viral strains.
HIV is a virus that attacks your immune system over time. If left untreated, HIV can increase your risk of opportunistic infections, like mpox.
Mpox is a viral disease similar to smallpox. It can cause swollen lymph nodes, a lesion-like rash, and fever.
While neither virus causes the other, there is some connection between the two.
Quick note on terminology: Mpox was once known as “monkeypox.” The
World Health Organization (WHO) renamed the virus at the end of 2022 to dissociate it from its racist, stigmatizing origins.
While anyone can contract mpox, people living with untreated HIV may be more susceptible to mpox.
The
The CDC found that 755 of the 1,969 people diagnosed with mpox during this time had a prior HIV diagnosis.
Researchers also noted that the weekly percentage of people living with HIV who developed a concurrent mpox infection increased over time — from 31% to 44% by July.
That said, people living with HIV are not a monolith.
“Clinically, someone with well-controlled HIV and robust CD4 counts is not at higher risk of severe mpox disease than someone who is HIV-negative,” said Anu Hazra, MD, an infectious disease specialist with Howard Brown Health in Chicago, Illinois.
It’s people living with advanced HIV — specifically those with CD4 counts under 350 — who are most at risk of mpox and death related to mpox, he said.
CD4 cells, sometimes known as T cells, are a type of white blood cell that make up your immune system. CD4 cells help protect your body from disease. HIV can damage these cells and cause CD4 levels to drop.
When CD4 levels are low, your body is less equipped to fight off potential infections, like mpox.
The mpox virus (MPXV) causes mpox.
“Most often, transmission occurs via skin-to-skin [contact] with someone who has mpox,” said Bradley Perkins, MD, chief medical officer at the biotechnology company Karius.
Specifically, this means
Although sexual activity is one way skin-to-skin contact may occur, it’s important to understand that mpox is not a sexually transmitted infection (STI) or disease (STD).
Prolonged skin-to-skin contact of any kind can transmit the virus from one person to another. It can also be transmitted through other forms of close contact, such as standing or talking face-to-face.
Breathing, talking, laughing, sneezing, and coughing all produce respiratory droplets that can transmit the virus.
People who are immunocompromised, which includes many people living with HIV, are more susceptible to mpox, explained James Walker, MD, a medical adviser with Welzo.
It’s imperative that these groups get vaccinated and reduce their risk of exposure by limiting contact with people who have an active mpox infection, he said.
The best thing you can do to reduce your risk of developing mpox is to get the mpox vaccine, said Hazra.
“The mpox vaccine is a two-dose vaccine, so it’s important to get both doses,” he explained. The second dose is administered 4 weeks after the first.
Beyond that, Perkins said it’s good practice to:
- wash your hands thoroughly and frequently
- avoid touching surfaces, materials, or objects that have been used by someone with an active mpox infection
- avoid direct contact with animals that have an active mpox infection, particularly rodents
People living with HIV can further reduce their risk by ensuring their HIV is well managed. This typically involves antiretroviral therapy (ART).
“When we help people with HIV improve their overall health and CD4 count recovery, we can also improve their prognosis if they do contract the virus,” explained Hazra.
It’s important to consult a clinician if you suspect you’ve been exposed to mpox or develop symptoms associated with mpox. This includes swollen lymph nodes, rash, and fever.
Mpox can be incredibly painful, noted Walker, so the sooner you start pain or antiviral medication, the better.
During your appointment, your clinician will swab any rashes, lesions, or sores that could be mpox and send the sample off for testing, said Hazra. This is the only way to accurately test for the mpox virus.
Blood tests aren’t recommended, as the virus only resides in the body for a short period of time. There are no urine or genital swab tests for mpox.
“The vast majority of mpox cases resolve on their own over the course of 3–6 weeks,” said Hazra.
However, many people choose to use medication to help manage the pain and discomfort associated with mpox lesions, he said.
“There are also antiviral medications that can be used to treat moderate to severe manifestations of the disease,” added Hazra.
People with advanced HIV who receive an mpox diagnosis may be prescribed additional antiviral therapy to help reduce the risk of further disease and death related to mpox, he explained.
The goal is to keep HIV-related immune destruction at bay so the body is better prepared to clear the mpox virus.
People who have a compromised immune system are more susceptible to infections like mpox. This includes people living with undiagnosed, untreated, or advanced HIV.
Getting tested for HIV is the only way to know your current status. If your test results are positive, your clinician will work with you to develop a treatment plan. Taking steps to manage your condition can help strengthen your immune system.
You can reduce your risk of mpox by getting vaccinated. Consult a healthcare professional to learn more.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.