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Volume 28, Number 10—October 2022

Epidemiology of Early Monkeypox Virus Transmission in Sexual Networks of Gay and Bisexual Men, England, 2022

Amoolya Vusirikala1, Hannah Charles1, Sooria Balasegaram, Neil Macdonald, Deepti Kumar, Ceri Barker-Burnside, Kerry Cumiskey, Michelle Dickinson, Michelle Watson, Oluwakemi Olufon, Katie Thorley, Paula Blomquist, Charlotte Anderson, Thomas Ma, Hamish Mohammed, Samantha Perkins, Karthik Paranthaman, Petra Manley, Obaghe Edeghere, Katy Sinka, and Mateo ProchazkaComments to Author 
Author affiliation: UK Health Security Agency, London, UK

Main Article


Characteristics and exposures of 45 interviewed persons with confirmed monkeypox, England, 2022*

Variables No. (%)
Cisgender men
45 (100)
White 35 (78)
Black 1 (2)
Asian 3 (7)
Mixed 3 (7)
3 (7)
Place of birth
United Kingdom 19 (43)
Europe, not including United Kingdom 12 (27)
South America 5 (11)
Other 8 (18)
1 (2)
Region of residence
London 39 (87)
Other regions in the United Kingdom
6 (13)
Sexual orientation
Gay 40 (89)
Bisexual 4 (9)
Heterosexual 0
1 (2)
No. sexual contacts in past 3 mo
1 4 (9)
2–3 6 (14)
4–9 13 (30)
>10 20 (47)
Prefer not to say/unknown
2 (3)
HIV prevention and care
HIV negative 32 (71)
Receiving PrEP 29 (91)
Living with diagnosed HIV 11 (24)
Receiving HIV treatment 11 (100)
Undetectable viral load 10 (91)
Prefer not to say/unknown HIV status
2 (4)
History of STI in past year
Yes 27 (60)
18 (40)
Travel abroad within 21 d before symptom onset
Yes, reported sexual activity 9 (20)
Yes, but no sexual activity 5 (11)
31 (69)
Exposure events within 21 d before symptom onset†
Festivals outside of the United Kingdom 5 (11)
Sex-on-premises venues 20 (44)
Private sex parties 9 (20)
Cruising grounds 7 (16)
None of the above
16 (36)
Sexual activity within 21 d before symptom onset‡
Sexual activity with new partners 37 (82)
Sexual activity with one-time partners 34 (76)
Sexual activity with occasional partners 24 (53)
Sexual activity with established partners 12 (27)
Sexual activity with women 2 (5)
Group sexual activity 20 (44)
Chemsex 10 (22)
Sexual activity with partners who are not regular UK residents 11 (24)
Sexual activity in locations different from city/town of residence 13 (30)
Sexual activity with partners met via geospatial dating apps 28 (64)
No sexual activity reported 2 (4)

*Sexual activity was defined as direct contact of a sexual nature, such as kissing, oral sex, and penetrative (vaginal, anal) sex. Some categories in this table were collapsed to avoid deductive disclosure. Median (interquartile range) age, 40 (32–43) y. PrEP, pre-exposure prophylaxis; STI, sexually transmitted infection. †Sex-on-premises venues, private sex parties and cruising grounds are activities that took place either in the United Kingdom or abroad. ‡New partner, person with whom the index case-patient is likely to have had sex on >1 occasion; one-time partner, person with whom the index case-patient has had sex on 1 occasion only; occasional partner, person with whom the index case-patient has had sex on >1 occasion and with whom there is an expectation of sex again on a sporadic or regular basis; established partner, primary partner or secondary partner (e.g., a long-term affair) (10); chemsex, use of drugs such as GHB (gamma-hydroxybutyrate), crystal methamphetamine, or mephedrone during sex.

Main Article

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Main Article

1These authors contributed equally to this article.

Page created: August 11, 2022
Page updated: September 21, 2022
Page reviewed: September 21, 2022
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