More than two-thirds of people diagnosed with mpox had prior STIs
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Key takeaways:
- Approximately 70% of people with mpox included in the study had prior chlamydia and/or gonorrhea infections.
- Forty-three percent of mpox cases were among people with HIV.
Prior infections with chlamydia and/or gonorrhea were common among people diagnosed with mpox, according to data gathered and assessed by the Chicago Department of Public Health.
“During the 2022-2023 mpox outbreak in Chicago, many cases of coinfection with other sexually transmitted infections (STIs) were reported. Our investigation sought to understand how many patients with mpox had experienced prior STIs (specifically HIV, chlamydia and gonorrhea) and if there were any differences among patients with mpox and those with mpox and other prior STIs,” Emily A.G. Faherty, PhD, Epidemic Intelligence Service Officer for the CDC and the Chicago Department of Public Health, told Healio.
“We hypothesized that if many mpox patients had prior STIs, then mpox vaccination would be recommended when individuals are evaluated for any STI in a syndemic approach to clinical care,” Faherty said.
Faherty and colleagues assessed a cohort of patients with confirmed and probable mpox detected between June 1, 2022, and March 31, 2023, who were interviewed by case investigators to identify demographic characteristics, clinical presentation, potential exposures, and to elicit contacts.
According to the study, the Chicago Department of Public Health matched mpox surveillance and case management data from this period to gonorrhea and chlamydia cases in the Illinois National Electronic Disease Surveillance System since Jan. 1, 2017, and to the enhanced HIV and AIDS Reporting System for HIV status at time of their mpox diagnoses.
Among 1,124 mpox cases — 848 (75%) of which were confirmed, 276 (25%) probable and 487 (43%) were among people with HIV.
Overall, the researchers found that prior STIs were common, with 70% of patients with mpox having previously been diagnosed with chlamydia and/or gonorrhea within 5 years before their mpox diagnosis.
Specifically, the study showed that 618 (55%) had a prior chlamydia infection, 648 (58%) had a prior gonorrhea infection and 408 (36%) had prior chlamydia and gonorrhea infections within the last 5 years. Of these patients, more than 400 (38%) had three or more chlamydia or gonorrhea episodes during the 5 years preceding their mpox diagnosis, including 229 people with HIV.
“Comprehensive STI assessment is recommended for patients with mpox. Improving uptake of HIV pre-exposure prophylaxis among persons who are HIV negative and bundling STI treatment with mpox could improve both HIV prevention and prevent new or severe mpox,” Faherty said. “Additional analyses are needed to better understand the role mpox can play in facilitating HIV and STI transmission and acquisition.”
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