Key facts

–  There have been a number of confirmed cases of monkeypox in the UK. Although monkeypox can affect anyone, the majority of those cases are among gay and bisexual men.

– Monkeypox is transmitted through close contact, so is likely being passed on during sex rather than sexual transmission.

– Everyone is being asked to be aware of the monkeypox symptoms, but it’s important gay and bisexual men are alert as it’s believed to be transmitting through sexual networks.

– If you have new unexpected or unexplained spots, ulcers or blisters anywhere on your body (including the face and/or genitals) or any of the other symptoms outlined below, then contact your local sexual health service by phone – not in person – or call 111 for advice.

– Symptoms include fever, headache, muscle aches, backache, swollen glands, chills and exhaustion.

– All calls to a GP, a clinic, and to 111 about monkeypox should be treated sensitively and confidentially.

– Close contacts who have symptoms will be advised to isolate for 21 days.

– Health protection teams are getting in touch with close contacts of anyone diagnosed with monkeypox. They will advise you what to do if you do not have symptoms.

Monkeypox transmission
Monkeypox can be passed on from person to person through:

You’re extremely unlikely to have monkeypox if:

The virus enters the body through broken skin (even if not visible), the respiratory tract, or the mucous membranes (eyes, nose, or mouth). The incubation period is the duration/time between contact with the infected person and the time that the first symptoms appear. The incubation period for monkeypox is between 5 and 21 days.

Monkeypox infection is usually a self-limiting illness and most people recover within several weeks. However, severe illness can occur in some individuals.

The first symptoms of monkeypox include:

A rash usually appears 1 to 5 days after the first symptoms. The rash often begins on the face, then spreads to other parts of the body. This can include the genitals and anus.

The rash is sometimes confused with chickenpox. It starts as raised spots, which turn into small blisters filled with fluid. These blisters eventually form scabs which later fall off.

The symptoms usually clear up in a few weeks. An individual is contagious until all the scabs have fallen off and there is intact skin underneath.

Geographic spread
The proportion of cases resident in London was more than 75% from the start of the incident up to 20 June 2022. This proportion declined to just over 60% in early July and has stayed at around 66% of cases since then. On 18 July 2022 the total number of monkeypox cases confirmed in the UK was 2,137. Most of these were diagnosed in England (2,050) and the majority of cases were in gay and bisexual men.

Monkeypox and HIV
There is limited evidence on monkeypox in people living with HIV, and most is based on research in countries where access to HIV treatment is low, and overall health outcomes are worse than in the UK. Currently people living with HIV should follow the same advice as the general population. Should evidence emerge that people with weakened immune systems are at greater risk of monkeypox, or ill-health from catching the virus, then updated information and advice will be made available.

Monkeypox and PrEP
Monkeypox does not affect effectiveness of PrEP (pre-exposure prophylaxis); therefore, people who use PrEP should continue to take it.

A safe smallpox vaccine, called Imvanex is available and currently offered to close contacts of people diagnosed with monkeypox and healthcare professionals who are seeing potential monkeypox cases. The vaccine reduces the likelihood of symptomatic infection and severe illness.

UKHSA has announced plans to make the vaccine more widely available – this will include gay and bisexual men who are more likely to be exposed to monkeypox. People are currently advised not to come forward for the vaccine until contacted.

UKHSA guidance for gay/bi/MSM:

This blog was written by our Sexual Health Outreach Worker, Chris Dunbar.

Sometimes, having sex in the safe confines of your bedroom just doesn’t cut it. You may be looking for somewhere new, seeking thrill or adventure, or just not be able to have the sex you want within your four walls. You may have heard someone talk about cruising, or have been asked if you want to go, but what does it actually mean?

Let’s have a look together at what it means, the laws, and general safety if you do decide to give it a go.



Cruising is walking or driving about certain areas, called cruising grounds, looking for a sexual partner. These meetings are usually one-off, anonymous encounters.

Cottaging is a term used to describe anonymous sex meetings in public toilets.


Where do the terms come from?

Cruising: The word originated as a gay slang term, sometime in the early 1960s, as a way for people who knew its meaning to arrange sexual meetings. It was a way to plan sexual encounters without attracting the attention of people who may wish to report them to the authorities, or inflict harm. The term is used many countries including the UK, the USA, and Australia.

Cottaging: The term cottaging originated in the early 1960s in the UK. It was used to describe public toilet blocks in public areas that resembled small cottages. Like the word cruising, cottaging was a code word for gay men to plan sex meetings without attracting unwanted attention. The term is only used in UK.


What is the difference between cruising and cottaging?

So, although both terms originated around the same time, and they both describe having sex in a public place, there is one major difference between the two.

There is no law specifically against cruising (having sex outdoors), as long as you are ensuring that you are not visible to other members of the public or causing a nuisance. Cottaging, on the other hand, is a different matter, as it is a criminal offence. Having sex in any public toilet or facility is against the law, even if you are doing it in a closed cubicle. Police or security often patrols these areas. If you are caught then you could be banned from the area or even arrested and potentially charged for sexual offences, which will be on your criminal record and would be flagged any time you have DBS check.

So from now on, we will focus on cruising.


Where do people go cruising?

Some of the most popular cruising sites tend to be in large parks, by canals, and in lay-bys. This is because there are often lots of nice, secluded areas that you can disappear into and not be seen by passers-by.


How do I find cruising sites?

Due to the secluded nature of cruising sites, you are not likely to just stumble upon one. So, if you are thinking you might like to give it a try, it is best to look on certain websites, such as Squirt. You will be able to find a full list of areas local to you, with directions of how to get there, safety advice for each particular site, and a message board to see who else may be going at certain times.


How do I do it?

Once you have found an area you would like to visit and arrived there, what do you need to do?  You will often spot other people walking around on their own, maybe looking at their phones, or just slowly looking about. It is unlikely that someone will just walk up to you and announce what they are there for, so it is important to keep a look out for signals, such as eye contact, a nod of the head, or something along those lines. If this happens, it generally means that they are interested and you can approach them.


Personal Safety

Making sure you are safe at all times is of the utmost importance. Due to the types of areas you are visiting, it is very unlikely that there will be CCTV in operation, or even lighting. It is advisable to keep all your personal items, such as mobile phones, wallets, and keys, well hidden on your person at all times, or leave them at home if you can. You may not want to tell people that you are going to meet somebody for sex, but it is advisable to tell someone that you are going out and check back in with them when you are home, so that they know you are safe.


The police and cruising

People can often be worried that if they go cruising, the police will be patrolling. This isn’t the case. The police would only tend to visit cruising grounds if someone has reported an annoyance complaint, or if there had been reports of an attack or offence there. The police DO NOT have the right to stop and search you just for being at a cruising ground, unless they have reason to believe you have or are about to commit a crime.

If you were to be arrested due to being seen having sex in a public place that was not secluded, or you had not made an effort not to be seen, you should always ask to speak to a duty solicitor at the police station before being interviewed or accepting a caution.


What do I do if something happens to me whilst cruising?

As with all public places, some areas are safer than others. It is always best to check notice boards on websites before going to a location, to make sure there have been no recent reports of attacks or crimes. Make sure you are going when you are sober, as if you are under the influence of alcohol or drugs, you are less likely to spot signs of danger. Staying close by where other people are cruising is advisable. If something were to happen, you would be able to shout or attract attention from someone else for help. Consent is still highly important, so knowing what you are ‘up for’, or willing to do, and sticking to that is crucial. If you say no, then it means no, and the same goes for if somebody says no to you – then you must not persist and try anyway.

If something were to happen to you whilst cruising, you must ensure that you report it. If you did not wish to talk to the police directly, then you can access support from a third party reporting service, such as Birmingham LGBT, who can offer you support and submit a report for you.

If you want any further advice on cruising, you can contact Birmingham LGBT on 0121 643 0821, or email