When it comes to men who have sex with men (MSM) and Monkeypox in Europe and North America I think a crucial bit of information would be this: Is the proportion of infected MSM with AIDS (compared to all infected MSM) about the same as in the MSM population or is it much higher?
If the proportion were about the same then the high number of MSM with Monkeypox would make this more or less an STD (not completely an STD, as AIDS isn’t completely an STD as well). The health impact of that should be limited. And that would lead me to strongly believe that there is (almost) no airborne transmission because that would not target primarily MSM.
If, however, there were primarily MSM with AIDS that suffer from Monkeypox in our countries, then the reason for that could be their immunocompromised status. That would lead me to suspect that there was a considerable asymptomatic spread of Monkeypox. And that could be quite dangerous for other immunocompromised populations.
Our base expectation for asymptomatic spread should be quite low, because previous variants of monkeypox and smallpox (mostly) didn’t spread like that. So I disagree with your “MSM with AIDS” scenario. It wouldn’t be that surprising for the spread to be contained to the particularly vulnerable AIDS population.
When it comes to men who have sex with men (MSM) and Monkeypox in Europe and North America I think a crucial bit of information would be this:
Is the proportion of infected MSM with AIDS (compared to all infected MSM) about the same as in the MSM population or is it much higher?
If the proportion were about the same then the high number of MSM with Monkeypox would make this more or less an STD (not completely an STD, as AIDS isn’t completely an STD as well). The health impact of that should be limited. And that would lead me to strongly believe that there is (almost) no airborne transmission because that would not target primarily MSM.
If, however, there were primarily MSM with AIDS that suffer from Monkeypox in our countries, then the reason for that could be their immunocompromised status. That would lead me to suspect that there was a considerable asymptomatic spread of Monkeypox. And that could be quite dangerous for other immunocompromised populations.
Our base expectation for asymptomatic spread should be quite low, because previous variants of monkeypox and smallpox (mostly) didn’t spread like that. So I disagree with your “MSM with AIDS” scenario. It wouldn’t be that surprising for the spread to be contained to the particularly vulnerable AIDS population.