Risk factors for mpox infection among MSM with STIs in northern Taiwan, 2022-2024.

INTRODUCTION

Since 2022, Mpox has emerged among men who have sex with men (MSM) in Taiwan. Data on local risk factors remain limited, particularly the role of sexual behavior and STI history.

METHODS

We conducted a retrospective case-control study at a regional hospital in Taoyuan from 2022 to 2024. MSM aged ≥18 years with at least one STI were included. Mpox cases were compared to STI-only controls. Data on demographics, HIV status, and behaviors were analyzed using Firth logistic regression.

RESULTS

Among 729 MSM, 42 had confirmed Mpox. Having more than two prior STIs was strongly associated with Mpox (aOR = 17.32; 95 % CI: 5.64-53.17). In contrast, HIV viral load >1000 copies/mL (aOR = 0.02) and multiple sexual partners (aOR = 0.22) were linked to lower odds of infection.

CONCLUSIONS

Multiple STIs were a strong predictor of Mpox. Lower infection rates among viremic or sexually active individuals may reflect behavior change or healthcare engagement. STI history may help guide targeted Mpox prevention.