Mpox virus and transmission through sexual contact: Defining the research agenda

A multicountry outbreak of mpox (formerly monkeypox) in 2022 has affected gay, bisexual, and other men who have sex with men disproportionately, highlighting the need to understand the role of sexual contact in transmission. While mpox virus (mpoxv) is not a novel pathogen and has been circulating in subsaharan Africa for many years, sexual transmission has not been well described. Epidemiological, clinical, and virological data indicate that transmission of mpoxv through sexual contact, both penetrative and nonpenetrative, is more effective than transmission through casual skin-to-skin contact. This article addresses many remaining questions about factors associated with the sexual route of mpoxv transmission and provides a framework within which research studies can be prioritised to guide policy and prevention needs.