The number of #mpox cases has dramatically decreased, but Dr. Demetre Daskalakis of the CDC tells us how to keep these numbers low and how mpox interacts with HIV.

The following is a transcript of the conversation between Karl and Dr. Demetre.

DEMETRE
MPox prevention is HIV prevention and care. HIV prevention and care is MPox prevention.

KARL
Hello there. Welcome to “Plus Talk” on Plus Life, where we’re all about turning positive into a plus. My favorite doctor, Dr. DEMETRE from the CDC joins us. Good to see you, sir. We’re talking monkeypox ’cause it’s been a year already.

DEMETRE
Yeah, love to talk MPox with you. Thanks for having me. And it has been a year

KARL
It’s been a year. It’s important. We’re coming up to everyone’s favorite time of the year, Pride, which obviously for a lot of us in the LGBTQIA+ community, it means getting together, it means large groups, it means celebrating. And I know that this time last year we were getting a bit nervous about that because of monkeypox. Let’s jump straight in. Where are we at? What’s the latest? Should we still be concerned?

DEMETRE
Great. So we are in a way different place than we were the last time that we spoke, which I think was actually in June, no, July, 2022. So we’re up to 30,422 cases in the US and we have 42 deaths. We’re gonna talk about those in a second because it’s really important as part of the plan here. So we have seen a just massive decrease in the number of cases, like over a 99% decrease from the peak of the outbreak that happened at the very beginning of August. That’s really good news. We, however, do have some really important flags that really make us want to really keep MPox on folks’ radar. So the first is we have really good modeling. So mathematical models forecasting… The way that you forecast weather, we’re forecasting MPox, and that MPox forecast says that unless we vaccinate more people, we in the United States could be at risk for outbreaks and potentially large outbreaks. So that job has not yet been finished. The other flag that we have is that we’re seeing… It’s a flag as well as some good news, actually. We’re seeing a cluster of cases in Chicago, and many of those are among vaccinated people. So that raises a flag, which is what’s going on with the vaccine, but also like how is the vaccine working. At the same time we’ve released amazing amounts of vaccine data through CDC, and that data really shows that the vaccine in two doses has a really good level of protection. Zero doses, zero protection. One dose, better protection. Two doses, somewhere between 66 and 87% protection, depending on the study. The other part about the Chicago outbreak, which is like good news, bad news. So yes, there’s an outbreak. People who are vaccinated have really mild symptoms. So that means that the vaccine is working even when it doesn’t prevent infection. So it looks as if it protects folks from more severe manifestations of MPox. So in a long-winded answer, the answer is keep it on your radar as we approach Pride. And if you haven’t gotten the vaccine and you see yourself in the folks who we recommend getting it, get that first dose. If you haven’t gotten that second dose, get the second dose.

KARL
Okay. We also live in a world of talking about booster shots, especially in a post-COVID world. Is a booster shot something that is available or should be considered for those of us like myself who have had two shots and are living with HIV?

DEMETRE
Yeah. So first let’s talk about the living with HIV. So one of the vaccine effectiveness studies that came out actually showed similar vaccine effectiveness in folks living with HIV to folks who don’t have HIV. That’s really important. The second component to your question about booster, there’s no recommendation currently for a booster.

KARL
So even though I got my second MPox shot in August of last year, here we are in June of this year pretty much. I’m still okay, I’m still covered.

DEMETRE
Yeah. So as of this date at… Now that we’re talking right now, May, 2023, there is no indication to get an additional dose. Like I said, we’re convening all the smart folks to take a look to see if anything needs to change in strategy, but right now there’s no indication for a change in strategy.

KARL
All right, and let’s just talk a little bit more about the HIV side of things, because…

DEMETRE
Yeah, I’d love to.

KARL
How important it is for those of us living with HIV to really, again, make sure we’re vaccinated. But now that we’re a year into it, give us a bit more of an update on what the studies have shown how it directly affects folks living with HIV.

DEMETRE
Karl, we have so much more information. So it’s great. So we often use the word syndemic, it’s kind of jargony. Let me tell you what it is.

KARL
I don’t even know how to spell that.

DEMETRE
When there’s interacting epidemics, interacting infections that are then made worse by social circumstances. And so we have seen in real life MPox enter the syndemic of HIV. And what I mean by that is that what we see is that people who are among people diagnosed with MPox, around 38% of them are living with HIV. When you look deeper into that group, those individuals who are not virally suppressed, not on medicines, and who have lower T-cells, tend to have more complications. That includes hospitalization. In fact, when you look at the folks who died of MPox in the US four, it’s 38 that were actually reported through a study at CDC, it really shows that the majority, over 90%, were living with HIV. But this is where it’s so important. MPox prevention is HIV prevention and care. HIV prevention and care is MPox prevention. Those folks weren’t in care. Many of them didn’t know their status. Almost none of them are on antiretroviral medicines. And their T-cells for the most part, except for one, less than 50, and the person who had a T-cell count over 50, their T-cell count was under 200. So it really speaks to the importance of making sure that we don’t just look at MPox in isolation. Getting folks who could benefit from HIV testing tested, important. Making folks aware of their status for HIV, important. Because it not only prevents HIV complications, it also prevents MPox complications. With that said, we also know that the vaccine works in immunocompromised people. And so it’s really important that if you’re living with HIV and you see yourself on the list of folks who could benefit, gay, bisexual, other men who have sex with men, transgender individuals who either have had or may have more than one partner, people who are living with HIV who have any of those risks and their partners, all qualify for vaccine. And all you have to do to get the vaccine is find it and say you want it. But what we also know about the people that died of MPox, only one of them was vaccinated. So we know vaccine works to prevent infection and when it doesn’t, it prevents severe outcomes even in people living with HIV. So thank you for modeling excellent behavior, Carl. But everyone else follow Carl’s lead. And if you haven’t gotten your first dose, get it. If you haven’t gotten your second, finish the job and get that one.

KARL
Yeah, I would say in the vaccine department, follow my lead. I’m not sure I’m the bastion of smart choices otherwise. You kind of touched on… Not all the time.

DEMETRE
Vaccines support your choices whichever direction they go in.

KARL
Correct.

DEMETRE
Which is good.

KARL
And you sort of touched on it a little bit there. In the last few moments I’ve got you, just it is still relatively easy for people to get this vaccine? Is it sort of, I can go into my local CVS or Walgreens or Walmart now? Or do I have to go through special clinics? A lot of people don’t want to go into LGBTQ centers. How easy, where can I get it?

DEMETRE
So for the most part, the vaccine has not made it into pharmacies because of pretty much very sort of complex issues around sort of what works in a pharmacy from the pharmacy perspective. So that’s really important to say. So I wish I could say you could walk up to Walgreens and get it, but what I can say is that there’s a vaccine locator that is available on the CDC website, also accessible from MPoxvaxmap.org. So M-P-O-X-V-A-X-M-A-P.org and that will also lead you to the site to be able to look at the locator. There are multiple types of sites that are actually carrying vaccine, from routine health providers all the way down to sexual health clinics. So there are definitely options. And I think one of the important things that we did is that we’ve very clearly messaged to the folks who are vaccine providers that they don’t have to sort of grill you on your sex life to see if you qualify for vaccines. So walking in and saying, “I want the vaccine,” you’re scheduling an appointment and saying, “I want the vaccine,” that’s enough to get it without additional hoo-ha.

KARL
Well, listen, we appreciate that. And I, as always, appreciate seeing you and having these chats. Short and sweet. That’s how we like it. But that’s the latest on MPox. Dr. DEMETRE, lovely to see you.

DEMETRE
Great to see you. Well, great to hear you, Carl, and thanks. And don’t call me short anymore. Just kidding. Talk to you soon. Thank you very much.

KARL
Thanks, Dr. DEMETRE. That is gonna do it for this episode of “Plus Talk.” We will put all of those fantastic websites up on the website. We’ll also throw some graphics up on screen here so people know how they can go and get vaccinated. Until next time, take care of yourself, get that vaccine if you haven’t. We’ll see you soon.