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MPOX 101: What Queer Folks Need to Know Without the Shame Spiral

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Mpox is a viral infection caused by the mpox virus (belonging to the Orthopoxvirus genus), a cousin of smallpox. While it’s generally milder than smallpox, it can still suck. Fever, rash, and painful sores are not a vibe. It’s not a new STI (in fact it's not really and STI at all), but it can spread during sex or close contact, and it's showing up in queer networks more than others. Unlike smallpox, which only infected humans, mpox can spread between humans and other animals (zoonotic), making eradication by vaccination tricky... unless we plan on chasing every squirrel (and the occasional spry twink) with a blow‑dart vaccine.


Anyone can get Mpox (even the family dog), but let’s be real: gay, bi, and queer men, trans and non-binary folks, and sex workers have been most affected in recent outbreaks. This isn’t because we’re morally depraved sex lunatics (ok, some of us might be, and slay to that), but because statistically, members of MSM communities are more likely to have multiple partners, attend sexual events, and visit back rooms, saunas, and sex on premises venues (Acharya et al., 2025). Add to that the fact that the virus entered our social and sexual circles first, and public health was too slow to act without stigma, creating a situation far too reminiscent of the HIV response in the 80s.


What Is Mpox?

Mpox is a viral infection caused by the mpox virus (belonging to the Orthopoxvirus genus), a cousin of smallpox. While it’s generally milder than smallpox, it can still suck. Fever, rash, and painful sores are not a vibe. It’s not a new STI (in fact it's not really and STI at all), but it can spread during sex or close contact, and it's showing up in queer networks more than others. Unlike smallpox, which was only contracted by humans, mpox has the ability to infect both human and non-human hosts making eradication by vaccination difficult.


Anyone can get it (even the family dog), but let’s be real: gay, bi, and queer men, trans and non-binary folks, and sex workers have been most affected in recent outbreaks (Acharya et al., 2025). This isn't because we’re “riskier,” but because the virus got into our social and sexual circles first and public health was too slow to act without stigma.


How Does It Spread?

Mpox spreads through:

  • Skin-to-skin contact, especially prolonged or intimate touch

  • Contact with sores, scabs, or bodily fluids

  • Touching things like towels, bedding, or clothing that have the virus on them

  • Respiratory droplets (especially in very close contact like kissing or cuddling)

  • Sexual activity, because, let’s be honest, it involves all of the aboveFs


You can also get it from group sex, kissing, massage, cuddling, or sharing toys or gear (clean your harnesses, babes!). Condoms don’t fully prevent it, though they still protect against STIs like syphilis, gonorrhea, and HIV, so don’t toss them out.


What Are the Symptoms?

Mpox symptoms can vary and sometimes look like other things (herpes, pimples, even ingrown hairs). But here’s what to look out for:

  • Fever, chills, swollen lymph nodes, fatigue

  • Painful or itchy rash, often starting on the face, genitals, or around the butt

  • Pimple-like or blistering sores that eventually crust and heal

  • Rectal pain, penile swelling, discharge, or bleeding especially if lesions are internal


Not everyone gets a full rash. Some folks only get one or two lesions. Others might not get a fever at all. Some people have very mild symptoms and don’t even realise they’re infected. That’s why we need awareness, not panic.


What If I Think I Have It?

First: Don’t panic. Don’t feel ashamed. Don’t ghost your hookup.

  • Avoid close contact (including sex or cuddling) until you’ve been checked out

  • See a GP or sexual health nurse (ideally one queer-friendly or trans-affirming)

  • Tell your partners, just like you would with an STI. Think of it as harm reduction, not confession

  • Get tested if possible, some clinics offer Mpox testing, especially if you have visible lesions


The good news is most cases are mild and self-limited (they burn out on their own), and do not require specific antiviral therapy. In severe cases your clinician may precribe an antiviral medication such as Tecovirimat (Tpoxx) to shake the virus (ASHM, 2024). And yes, it’s okay to be scared or embarrassed but trust us, health workers have seen it all and most will respond with compassion and confidentiality.


What About the Vaccine?

We love a vaccine moment. The JYNNEOS (or Imvanex) vaccine is available in many parts of Australia and worldwide (The Australian Immunisation Handbook, 2024). It's not 100% protective, but it can reduce your risk of getting Mpox or having a more severe illness.

  • Two doses give stronger protection

  • You can get vaccinated before or after exposure (ideally before)

  • Prioritised groups often include GBMSM, trans people, non-binary folks, people on PrEP, and sex workers

If you're eligible, get the damn shot. It’s safe, free in many places, and it’s one more layer of collective care.


Prevention Without Paranoia

You don’t need to swear off sex, intimacy, or parties, just be mindful. Prevention can be sexy, too. Try:

  • Limiting anonymous or high-contact partners during outbreaks

  • Checking in with partners about symptoms or known exposures

  • Washing hands and toys, changing sheets, cleaning shared surfaces

  • Getting vaccinated and encouraging your friends to do the same

  • Creating safer sex plans if you’re immunocompromised or live with someone who is


If you run or attend sex-positive spaces, you can advocate for things like vaccine info, handwashing stations, and clear messaging without turning it into a cop show. Public health works better when it’s designed with us, not at us.


Care Over Stigma

Mpox isn’t a punishment for sex or queerness. It's a public health issue that needs care, honesty, and community. If you or someone you know has it, remember:

  • Rest, hydrate, manage pain or discomfort

  • Ask your clinic about antivirals, stool softeners, or wound care if needed

  • You’re still lovable, worthy, and sexy (even in a bathrobe with a rash)


Solidarity, not shame. Community care, not panic.


Final Word

Whether you're soaking up sauna steam, cuddling your partner, or dancing shirtless at a street party, your health matters. Mpox is real, but so is queer joy, resilience, and our power to look after each other. Let’s keep the fun, ditch the shame, and protect our community with facts, not fear. Mpox can be confronting, but when the system falls short, we stand up for our own health and for each other.


Want more queer, trans-inclusive sexual health info? Stick with us at Secret Sex Project.


References

The information provided in this blog post is intended for general educational purposes only and does not constitute professional medical advice, diagnosis, or treatment. While I am a registered health practitioner, this content is not a substitute for consultation with a qualified healthcare professional who can consider your individual circumstances.


This blog reflects my personal views and professional experiences and does not represent the views of my employer or any affiliated organisations.


In line with AHPRA guidelines, no testimonials are included, and this blog post is not intended to advertise or promote specific services or treatments.

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