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

Wei-Yen Chen; Shu-Hsing Cheng; Cheng-Pin Chen; Shu-Yuan Lee; Shin-Yen Ku; Shu-Ting Gan; Chen-En Hsieh; Chien-Yu Cheng

doi:10.1016/j.jiac.2025.102750

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

J Infect Chemother. 2025 Jun 10;31(8):102750. doi: 10.1016/j.jiac.2025.102750. Online ahead of print.

Authors

Wei-Yen Chen¹, Shu-Hsing Cheng², Cheng-Pin Chen³, Shu-Yuan Lee¹, Shin-Yen Ku⁴, Shu-Ting Gan⁵, Chen-En Hsieh¹, Chien-Yu Cheng⁶

Affiliations

¹ Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
² Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; School of Public Health, Taipei Medical University, Taipei, Taiwan.
³ Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; School of Clinical Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
⁴ Department of Nursing, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
⁵ Division of Biostatistics, Department of Research and Development, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
⁶ Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; Institute of Public Health, School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan. Electronic address: s841060@gm.ym.edu.tw.

PMID: 40505967
DOI: 10.1016/j.jiac.2025.102750

Abstract

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.

Keywords: HIV; MSM; Mpox; Risk factors; Sexually transmitted infections; Taiwan; Vaccination coverage.

Copyright © 2025 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.