Table 2.
Demographic and Clinical Characteristics Associated With Mpox Diagnosis Among CNICS Participants, N = 19,177, 1 June 2022–31 May 2023
| RR | 95% CI | P Value | aRRa | 95% CI | P Value | |
|---|---|---|---|---|---|---|
| Demographic characteristics | ||||||
| Geographic region | ||||||
| Midwest and Northeast | Ref. | … | … | Ref. | … | … |
| Southeast | 1.01 | .69–1.48 | .9 | 0.88 | .60–1.29 | .5 |
| West Coast | 3.1 | 2.21–4.36 | <.001 | 2.22 | 1.58–3.13 | <.001 |
| Age | ||||||
| <40 | 3.54 | 2.93–4.29 | <.001 | 2.25 | 1.82–2.78 | <.001 |
| ≥40 | Ref. | … | … | Ref. | … | … |
| Sex | ||||||
| Female | … | … | … | … | ||
| Male | NCb | … | NCb | … | ||
| Trans identity reported | ||||||
| No | Ref. | … | … | Ref. | … | … |
| Yes | 0.62 | .28–1.38 | .2 | 0.51 | .24–1.07 | .08 |
| Race/ethnicity | ||||||
| Black, non-Hispanic | Ref. | … | … | Ref. | … | … |
| Hispanic or Latine | 3.21 | 2.50–4.13 | <.001 | 1.82 | 1.39–2.38 | <.001 |
| White, non-Hispanic | 1.34 | 1.05–1.71 | .02 | 1.28 | 1.01–1.63 | .04 |
| Another race, non-Hispanic | 1.92 | 1.28–2.86 | .002 | 1.15 | .76–1.73 | .5 |
| Clinical characteristics | ||||||
| CD4 count (cells/μL) | ||||||
| ≥500 | Ref. | … | … | Ref. | … | … |
| 350–499 | 1.19 | .91–1.54 | .2 | 1.21 | .93–1.57 | .2 |
| 200–349 | 1.43 | 1.07–1.91 | .02 | 1.41 | 1.05–1.91 | .03 |
| <200 | 1.16 | .78–1.72 | .5 | 1.16 | .79–1.73 | .4 |
| HIV viral load (copies/mL) | ||||||
| Undetectable (<50 copies/mL) | Ref. | … | … | Ref. | … | … |
| Detectable | 1.67 | 1.32–2.12 | <.001 | 1.59 | 1.25–2.02 | <.001 |
| ART status | ||||||
| On ART | Ref. | … | … | Ref. | … | … |
| Not on ART | 2.7 | 1.80–4.03 | <.001 | 2.15 | 1.39–3.31 | .001 |
| Recent chlamydia diagnosisc | ||||||
| No | Ref. | … | … | Ref. | … | … |
| Yes | 5.6 | 4.50–6.96 | <.001 | 3.5 | 2.76–4.45 | <.001 |
| Recent gonorrhea diagnosisc | ||||||
| No | Ref. | … | … | Ref. | … | … |
| Yes | 6.84 | 5.58–8.38 | <.001 | 4.6 | 3.70–5.71 | <.001 |
| Recent syphilis diagnosisc | ||||||
| No | Ref. | … | … | Ref. | … | … |
| Yes | 5.37 | 4.30–6.70 | <.001 | 3.84 | 3.02–4.89 | <.001 |
| Recent bacterial STIc | ||||||
| No | Ref. | … | … | Ref. | … | … |
| Yes | 7.39 | 6.12–8.92 | <.001 | 5.23 | 4.27–6.41 | <.001 |
| Diabetes | ||||||
| No | Ref. | … | … | Ref. | … | … |
| Yes | 0.17 | .10–.29 | <.001 | 0.25 | .14–0.43 | <.001 |
| History of HCV | ||||||
| No | Ref. | … | … | Ref. | … | … |
| Yes | 0.67 | .50–.91 | .01 | 0.82 | .60–1.11 | .2 |
| FIB-4 | ||||||
| ≤1.45 | Ref. | … | <.001 | Ref. | … | … |
| >1.45 | 0.27 | .18–.39 | 0.38 | .26–.55 | <.001 | |
| Alcohol use (AUDIT-C) | ||||||
| Not at risk | Ref. | … | … | Ref. | … | … |
| At riskd | 1.41 | 1.04–1.91 | .03 | 0.99 | .72–1.36 | .9 |
| Binge alcohol usee | ||||||
| No | Ref. | … | … | Ref. | … | … |
| Yes | 1.82 | 1.41–2.35 | <.001 | 1.23 | .94–1.60 | .1 |
| Depression | ||||||
| None to mild (PHQ-9: 0–9) | Ref. | … | … | Ref. | … | … |
| Moderate to severe (PHQ-9: 10–27) | 1.52 | 1.15–2.02 | .003 | 1.17 | .88–1.57 | .3 |
| Anxiety | ||||||
| No panic symptoms | Ref. | … | … | Ref. | … | … |
| Any panic symptoms | 1.37 | 1.04–1.79 | .02 | 0.99 | .74–1.31 | .9 |
| Protective mpox or smallpox vaccine dosesf | ||||||
| 0 | Ref. | … | … | Ref. | … | … |
| 1 or more | 0.29 | .19–.47 | <.001 | 0.16 | .10–.25 | <.001 |
Abbreviations: ART, antiretroviral therapy; AUDIT-C, Alcohol Use Disorders Identification Test-Consumption; CI, confidence interval; FIB-4, Fibrosis-4 hepatic fibrosis score; HCV, hepatitis C virus; IQR, interquartile range; NC, not calculable; PHQ-9, Patient Health Questionnaire 9 (depression); PRO, patient reported outcome; STI, sexually transmitted infection.
Adjusted using disease risk scores, constructed independently for each exposure of interest using the following: CNICS site, age, race/ethnicity, any recent bacterial STI, diabetes, history of HCV.
Not calculable; cases were exclusively male sex at birth.
Chlamydia, gonorrhea, or syphilis infection within 12 mo before mpox diagnosis, or within 12 mo before most recent clinic visit for those not diagnosed with mpox.
At risk alcohol use defined as AUDIT-C score ≥5 for male sex, ≥4 for female sex assigned at birth.
Any binge drinking in 12 mo before alcohol patient-reported outcomes, defined as consuming ≥4 (female sex at birth) or ≥5 (male sex at birth) drinks on one occasion.
Protective vaccine doses include all ACAM2000 or MVA-BN vaccine doses for people without mpox and only ACAM2000 or MVA-BN vaccine doses received ≥14 d prior to diagnosis among those with mpox.