The Proposed Policy: HIV screening for Mpox patients in Bangkok

Abstract

Mpox (Monkeypox) is an infectious disease caused by the mpox virus. Patients with concurrent Human Immunodeficiency Virus (HIV) often experience more severe symptoms. HIV screening is therefore an important measure for understanding the severity of mpox and for controlling the issue of AIDS. The objectives of this study are to examine the association between mpox symptoms and HIV infection, and to provide recommendations for HIV screening guidelines for mpox patients in Bangkok, which has the highest number of mpox cases in Thailand. This study was a cross-sectional analytical study using the data from the mpox surveillance system of Institute for Urban Disease Control and Prevention, Department of Disease Control, from 21^st July 2022 to 31^st December 2023. Data were analyzed using descriptive and inferential statistics. The study found that there were 409 mpox patients in Bangkok, of which 404 were identified as male by birth (98.78%) and 402 were identified as gender-diverse people (98.29%). 142 patients (34.72%) were diagnosed at private healthcare facilities. The three most common clinical manifestations were rash, fever, and myalgia. 172 patients (42.05%) were infected with HIV. Rash on the extremities and sore throat symptoms were associated with HIV infection. The odds of HIV-infected cases experiencing rash on the extremities and sore throat were 1.98 (95%CI: 1.06 - 3.73) and 2.72 (95%CI: 1.28 - 5.82) times higher, respectively, compared to HIV-uninfected cases. The results of the study suggest that service providers should consider counseling for HIV screening in mpox cases, as well as individuals with diverse sexualities, who are considered a risk group according to the Thailand National Guidelines on HIV/AIDS Treatment and Prevention.