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Among the 45 cases, 30% had had sex in a city outside their usual place of residence, 20% had taken part in sexual activity abroad and 24% had had sex with men who were not UK residents.
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“Sexual networks involved in this outbreak are interconnected both within and without the UK”, the UKHSA said. In that group 60% had been diagnosed with a sexually transmitted infection during the previous year, 44% had had more than ten sexual partners in the preceding three months and the same proportion had taken part in group sex while the infection was incubating. Among the 45 interviewed 98% had had sex with other men during the incubation period. “Findings show that monkeypox is being transmitted in geographically diffuse sexual networks”, the report added. In terms of their sex, 311 of 314 confirmed cases were men, with three women. “A high proportion of England cases were known to be London residents”, it said, adding that 224 of 276 people for whom they had a home address lived in the capital. The UKHSA report is based on close scrutiny of the history of the 336 laboratory-confirmed cases that had been identified in the UK by 8 June, including detailed questionnaires that 152 cases filled in. Tracing all the sexual partners of men who have contracted monkeypox will be hard, the UKHSA admitted, as “most cases reported having sexual contact with new or casual partners … where contact details were unavailable for tracing”. Incubation lasts anywhere between five and 21 days. In addition, 64% had met new sexual partners during their incubation period through a dating app. Interviews it has conducted with 45 men with monkeypox specifically about their sexual health found that 44% had visited “sex-on-premises venues” in the UK or abroad, such as saunas, sex clubs and dark rooms, while they were incubating the infection. The same overwhelming majority of cases – 99% – involve men who are gay, bisexual or have sex with other men, the UKHSA said.