JMIR Publications

ABSTRACT

Background:

Men who have sex with men (MSM) are at a high risk of mpox infection. HIV and metabolic diseases are prevalent in this population and may be related to mpox risk.

Objective:

This study examined the potential interaction between HIV infection and metabolic comorbidity in relation to self-reported mpox among MSM in China.

Methods:

A cross-sectional study was conducted among MSM aged 18–76 years from October 2023 to March 2024 in six representative provincial regions of China. Participants completed an anonymous questionnaire on recent voluntary HIV testing result, physician-diagnosed mpox, and metabolic diseases (hypertension, diabetes mellitus, hyperlipidemia). Additive and multiplicative interactions between HIV infection and metabolic comorbidity for mpox infection were examined.

Results:

Among the 2,403 MSM, 2.3% reported mpox. Both HIV infection and metabolic comorbidity were associated with higher odds of self-reported mpox, and a greater number of conditions showed a dose-response pattern (per-condition trend OR 3.20; 95% CI 2.06–4.90). The multiplicative interaction term was not statistically significant. Additive interaction metrics suggested a possible excess risk when HIV and metabolic comorbidity co-occurred (RERI 10.23, 95% CI 0.87–32.72; AP 0.71, 95% CI 0.04–0.86; SI 4.28, 95% CI 1.12–16.38).

Conclusions:

This study suggests that HIV infection and metabolic comorbidity were each associated with higher odds of self-reported mpox, with a possible additive interaction. Therefore, there is a need for interventions targeting MSM who have both HIV infection and metabolic comorbidity, addressing the comprehensive health needs of this population.