HIV and Sexually Transmitted Infections Among Persons with Monkeypox - Eight U.S. Jurisdictions, May 17-July 22, 2022

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• The current global monkeypox outbreak disproportionately affects gay, bisexual, and other men who have sex with men (MSM).
• Previous outbreaks linked concurrent human immunodeficiency virus (HIV) infection to poorer monkeypox clinical outcomes.
• Understanding the interplay of monkeypox, HIV, and sexually transmitted infections (STIs) is critical for public health response.

Purpose of the Study:

• To analyze HIV and STI diagnoses among individuals with monkeypox in the U.S.
• To assess clinical differences in monkeypox presentation based on HIV infection status.

Main Methods:

• Matched surveillance data from eight U.S. jurisdictions for monkeypox, HIV, and STI diagnoses.
• Analysis of data from 1,969 individuals diagnosed with monkeypox between May 17 and July 22, 2022.
• Comparison of clinical features between individuals with and without HIV infection.

Main Results:

• HIV prevalence was 38% among persons with monkeypox; 41% had a recent STI diagnosis.
• Among those with monkeypox and HIV, 94% received HIV care, and 82% had viral suppression (<200 copies/mL).
• Individuals with HIV infection were more likely to be hospitalized (8% vs. 3%) compared to those without HIV.

Conclusions:

• Persons with HIV infection and STIs are overrepresented in the monkeypox outbreak.
• Public health strategies should integrate HIV and STI care systems to curb monkeypox incidence in affected populations.
• Prioritizing vaccination for individuals with HIV/STIs and routine screening for monkeypox, HIV, and STIs are recommended.