Mpox in 2026: What Gay and Bisexual Men Should Know Now
Mpox is still spreading among gay and bisexual men. Here is what the latest data, vaccines and prevention advice mean for you.
Photo: RainbowNews Editorial
Mpox has not disappeared. The virus, once called monkeypox, still spreads in Europe and beyond. Most new cases in 2025 and 2026 are among men who have sex with men. The World Health Organization (WHO) ended the global health emergency in May 2023, but kept mpox on its watch list. In August 2024, a new emergency was declared because of a different strain in Africa. For gay and bisexual men in Europe, the message from health authorities is simple: get vaccinated, know the symptoms, and act fast.
What the latest numbers show
The European Centre for Disease Prevention and Control (ECDC) reports that mpox cases in the EU stayed low but steady through 2025. Most infections are clade IIb, the strain linked to the 2022 outbreak. A second strain, clade Ib, has been found in travellers returning from Central Africa. The Dutch RIVM confirmed several clade Ib cases in 2024 and 2025, all linked to travel.
Globally, the Democratic Republic of the Congo remains the hardest-hit country. The WHO recorded more than 20,000 suspected cases there in 2024. Children and adults are both affected. In Europe, the picture is different: roughly 95 percent of cases are men, and most report sex with other men in the weeks before symptoms started.
How mpox spreads
Mpox spreads mainly through close skin-to-skin contact. Sex is one of the most common routes, but not the only one. The virus can also pass through:
- Kissing and prolonged face-to-face contact
- Shared bedding, towels or sex toys
- Contact with sores or scabs
- Respiratory droplets during very close contact
Condoms lower the risk but do not block it fully. The virus lives in skin lesions, which often appear outside the area a condom covers.
Symptoms to watch for
Mpox symptoms usually start 5 to 21 days after exposure. The first signs can feel like the flu: fever, headache, muscle pain and swollen lymph nodes. Within a few days, a rash appears. The rash can show up on the genitals, anus, mouth, hands or face. Lesions go through stages: flat spots, raised bumps, blisters, then scabs.
Many recent cases have been mild. Some men only get a few sores and no fever. That makes mpox easy to miss or mistake for another sexually transmitted infection. If you have any unusual sore, especially after recent sex with a new partner, see a doctor or sexual health clinic.
Vaccination: who should get it
The MVA-BN vaccine, sold as Jynneos or Imvanex, protects against mpox. Studies published in The Lancet and by ECDC in 2024 show that two doses cut the risk of infection by around 70 to 80 percent. One dose offers partial protection.
In the Netherlands, the GGD offers the vaccine free of charge to men who:
- Have sex with men and use or are eligible for PrEP
- Have had a bacterial STI in the past year
- Have multiple sex partners
- Work in sex work
Similar programmes run in Germany, Belgium, France, Spain and the United Kingdom. If you were vaccinated in 2022 or 2023 and only got one dose, health authorities now recommend a second dose. Protection wanes over time, and a booster may be advised for high-risk groups, though research on this is still ongoing.
What to do if you think you have mpox
Act quickly. Contact your GP, a sexual health clinic or the GGD. Tests use a PCR swab from a sore. Results usually come back within a few days. While you wait:
- Avoid sex and close skin contact
- Do not share towels, bedding or clothing
- Tell recent sex partners so they can get tested
- Cover sores if you need to leave home
Most people recover within two to four weeks without specific treatment. Painkillers and good wound care help. Severe cases, especially in people with untreated HIV, may need hospital care. The antiviral tecovirimat is available in some countries, though a 2024 US trial in the Congo showed it did not shorten illness as hoped. Research continues.
Mpox and HIV: an important link
Men living with HIV who are not on effective treatment face a higher risk of severe mpox. A 2023 study in The Lancet found that people with advanced HIV had more lesions, longer illness and higher death rates. For men on stable HIV treatment with a suppressed viral load, the risk is similar to that of HIV-negative men.
This is one more reason regular sexual health checks matter. Many clinics now offer combined testing for HIV, other STIs and mpox vaccination in one visit. If you want to read more about HIV prevention research, see our overview of where HIV vaccine science stands in 2026.
Practical prevention tips
Beyond vaccination, simple steps lower your risk:
- Check yourself and partners for sores before sex
- Reduce the number of anonymous partners during local outbreaks
- Wash sex toys between uses and do not share them
- Stay informed through the GGD, RIVM or your national health agency
Some men also rethink chemsex settings, where close contact with many partners raises exposure risk. Our article on sober sex parties and harm reduction covers that trend in more detail.
The bigger picture
Aidsfonds and other public health groups stress that mpox is not a "gay disease". The virus can infect anyone. But because the 2022 outbreak spread through sexual networks of men who have sex with men, that group remains most affected in Europe. Targeted vaccination is the most effective public health response, not stigma.
Researchers are also watching whether clade Ib will establish itself outside Africa. So far, European cases have been contained, but health authorities expect more imported infections. Strong testing, fast contact tracing and high vaccine uptake are the tools that keep numbers low.
The takeaway
If you are a gay or bisexual man and have not yet had two doses of the mpox vaccine, contact your local GGD or sexual health clinic. Vaccination is free in most European countries for eligible groups. Know the symptoms, check your skin, and do not wait if something looks off. Mpox is manageable when caught early, and prevention works.