SAN FRANCISCO (KRON) — The annual Dore Alley Festival happened Sunday in San Francisco’s SoMa neighborhood despite growing concerns around the spread of monkeypox. The virus has been predominantly spreading among gay and bisexual men who make up the majority of the festival’s attendees.

The leather and fetish fair draws thousands of people to San Francisco.

The event comes after the city just declared a public health emergency for monkeypox as the virus continues to spread.

“I think that the risk is not zero,” UCSF Infectious Disease Specialist Dr. Peter Chin-Hong said. “I think if people are smart and know how monkeypox is spread, they can avoid it.”

Chin-Hong says the risk of contracting the virus at events like Dore Alley is very low. However, that risk increases based on intimate interactions with others.

“Prolonged skin-to-skin contact and possibly through sexual transmission, although skin-to-skin contact is the main thing,” Chin-Hong added. “So that’s large. In terms of medium, that will be prolonged kissing through saliva, but it requires hours. Hugging by itself, giving a high five, shaking somebody’s hand is not going result in transmission.”

Event organizers say they’re working with the city’s public health department to provide on-site outreach and education.

Despite precautions, Chin-Hong expects to see more cases after this weekend.

“I expect a lot of activity next week in terms of alerts,” Chin-Hong said.

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Monkeypox is not confined to the queer and trans community, and other large events can also pose risks. Dr. Chin-Hong says it’s less about the events themselves and more about the activities that take place afterwards.