Research published July 21, 2022, in the
New England Journal of Medicine shows 98% of cases have been detected in men who have sex with men.
But messaging about who is most at risk of contracting monkeypox isn't the only thing that scientists and public health experts are unsure about.
Experts still don't know exactly how monkeypox is transmitted.
The New England Journal of Medicine study, which analyzed the samples of over 520 infections across 16 countries from April to June 2022, indicates that in 95% of cases, the virus was spread through "sexual activity."
But the authors say that "there is no clear evidence of sexual transmission through seminal or vaginal fluids" and that transmission is only proven to occur through large respiratory droplets, close or direct contact with skin lesions and "possibly through contaminated fomites." Fomites are things like cloths and kitchen utensils that may carry a virus.
What we know for sure: The virus is spread through very close contact between two people. This can involve cuddling and kissing as well as genital contact.
"Monkeypox is almost certainly sexually transmitted," said Paul Hunter, a professor of health protection at the Norwich Medical School in the UK.
"But my uneasiness about labeling it as a [sexually transmitted infection] is that for most [STIs] wearing a condom or avoiding penetration or direct oral-anal/oral-genital contact is a good way of
preventing transmission. But for monkeypox, even just naked cuddling is a big risk."