Impact of Targeted Outreach to Increase Linkage to Preventative Services for Patients Tested for Mpox.

Abstract

Early in the Mpox outbreak, individuals presenting for Mpox testing often did not receive comprehensive sexually transmitted infection (STI) screening upon presentation. This study aims to assess the impact of targeted outreach on linkage to STI and HIV screening and HIV pre-exposure prophylaxis (PrEP) counseling for individuals presenting for Mpox testing. Individuals who had tested for Mpox were contacted via an existing STI outreach team in Dallas, Texas, to engage in STI/HIV screening and other preventive services between June 2022 and March 2023. On retrospective chart review, 414 individuals were tested for Mpox with 203 PCR-confirmed cases. 238/414 (58%) were previously diagnosed with HIV. 76/176 (43%) of individuals with unknown HIV status were screened for HIV, and six new cases of HIV were identified. One-third (136/414) were also tested for other STIs (chlamydia, gonorrhea, or syphilis), with 45 new cases identified. 94/414 (23%) individuals were contacted for outreach after initial Mpox testing. Patients who received outreach were more likely to be tested for HIV (10/26 [38.4%]) compared with those who did not receive outreach (19/144 [13.3%]) (p < 0.001) and more likely to undergo additional STI testing (58/94 [62%] vs. 109/320 [34%]) (p < 0.001). More individuals in the outreach group were counseled on starting PrEP than in the non-outreach group (14/26 [53.8%] vs. 8/144 [5.6%]) (p = 0.0016). Targeted outreach increased screening for HIV and other STIs and counseling for PrEP among patients presenting for Mpox testing. Strategies to increase linkage to preventive services are needed to reduce coinfections of Mpox, HIV, and other STIs.