Modeling the Impact of Sexual Networks in the Transmission of Monkeypox virus Among Gay, Bisexual, and Other Men Who Have Sex with Men — United States, 2022

Abstract

On August 26, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Transmission of Monkeypox virus (MPXV) during the 2022 multinational monkeypox outbreak has been associated with close contact, primarily sexual behavior, between men (1). Survey data suggest that gay, bisexual, and other men who have sex with men (MSM) have taken steps to protect themselves and their partners from monkeypox, including reducing one-time sexual partnerships (2). CDC simulated dynamic network models representing the sexual behavior between MSM. Men with more than one partner in the preceding 3 weeks had 1.8–6.9 times the risk for acquiring monkeypox as did men with only one partner. Although one-time partnerships represented <3% of the total daily partnerships and 16% of the sex between men on any given day, they accounted for approximately 50% of MPXV transmission. In this model, a 40% decrease in one-time partnerships yielded a 20%–31% reduction in the percentage of MSM infected and a delay in the spread of the outbreak. A decrease in one-time partnerships not only decreased the final percentage of MSM infected, but it also increased the number of days needed to reach a given level of infection in the population, allowing more time for vaccination efforts to reach susceptible persons. If decreasing one-time partnerships were combined with additional mitigation measures such as vaccination or shorter time from symptom onset to testing and treatment, this effect would be higher. Reductions in one-time partnerships, a change in behavior already being reported by MSM, might significantly reduce MPXV transmission.