(P47) STI TESTING AND DIAGNOSIS RATES AMONG PATIENTS WITH MPOX IN 2 POPULOUS US CITIES, 2022

Background:
The 2022 mpox epidemic was recognized as a sexually transmitted infection (STI) and associated with an increase in other STIs. However, it is likely that many patients were not offered testing, and rates of STIs were underestimated.

Methods:
We obtained electronic medical record data from three large clinical centers in New York City, New York, and Houston, Texas of patients with mpox confirmed through orthopoxvirus PCR testing from June 25 to October 17, 2022. Chart review was conducted to supplement data. We calculated descriptive statistics for new diagnoses of syphilis, chlamydia, and gonorrhea.

Results:
Of 403 individuals diagnosed with mpox, the median age ranged from 30 to 35 years across the three centers. 96.5% of the participants were male at birth. 228 participants (56.5%) were people living with HIV. 228 out of the 403 patients (56.5%) presented with genital lesions. Only 211 patients out of 403 patients were tested for STIs (52.4%) within 2 weeks of their mpox diagnosis. 70 patients were diagnosed with a new STI at the time of their mpox visit.  

At the initial visit, there were 31 cases of new syphilis diagnosed. There were 4 new diagnoses of genitourinary chlamydia, 6 new diagnoses of rectal chlamydia and 1 new diagnosis of throat chlamydia. There were 2 new diagnoses of genitourinary gonorrhea, 17 new diagnoses of rectal chlamydia, and 14 new diagnoses of throat gonorrhea. Without extragenital testing, 38 new diagnoses of chlamydia or gonorrhea would have been missed (86.3%).

Conclusion:
Slightly more than half of patients with mpox were tested for STIs, despite many having genital lesions that could increase STI transmission risk. Many new diagnoses of STIs were observed, suggesting that undertesting likely led to underdiagnosis of STIs in an at-risk population. Extragenital testing detected most new chlamydia and gonorrhea diagnoses, emphasizing the importance of extragenital testing.