Dr David Koren on At-Risk Populations, Educational Efforts in Monkeypox

David E. Koren, PharmD, MPH, BCPS, AAHIVP, FIDSA, infectious disease clinical pharmacist at Temple University Hospital, discussed the risk posed by monkeypox among immunocompromised individuals and men who have sex with men, as well as the need for educational efforts to address misconceptions tied to the disease.

With monkeypox having been around for decades, educational efforts are needed to address misconceptions regarding at-risk populations and how the disease develops and is transmitted, said David E. Koren, PharmD, MPH, BCPS, AAHIVP, FIDSA, infectious disease clinical pharmacist at Temple University Hospital.


With anywhere between 30% and 51% of individuals with monkeypox also having coinfection with HIV, does this change the approach to prevent the spread of monkeypox?

I think this data is very interesting because this may actually be related to the amount of testing that we're doing in the HIV community. So, the question really is, is it that people with HIV are more at risk for developing monkeypox or are we just seeing those patients in the health care system more regularly? Or are they more connected to care, meaning that we're able to test those patients more readily.

I think that we [should] make sure that we not only focus on patients who are living with HIV, but rather all patients at risk, such as immunocompromised patients as a whole, those who have had solid organ transplants, women who are pregnant, anything of that nature. It's really not just one specific category of people, but rather looking at the population as a whole and doing what we can, [such as] delivering vaccines effectively to people who are most at risk for severe infection.

As gay and bisexual men are at-risk populations for monkeypox, what can people do to prevent similar stigmas we saw with the HIV epidemic?

This is a very interesting question, because we are perpetually faced with stigma as it presents in different forms. I looked at an article today that was sent to me, that there are certain laboratories refusing to draw labs for patients who are experiencing a monkeypox infection. It is very important that we as health care practitioners understand a virus that we know vs a virus that we don't.

We know what [monkeypox] is; this has been around since 1970. So, doing concerted education efforts, not only among patients, but also of the general health care delivery world, of what this is, how it can be transmitted from person to person, and how it can't, and what does that really mean in terms of our individual risk perceptions.

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