CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

1091 WITHDRAWN

59 years, 6 (66.7%) were Hispanic/Latinx, and 4 (44%) were living with HIV. The time interval from first to second infection was 266 to 608 days (median 425 days). One person had received a single dose of the JYNNEOS vaccine prior to their first infection. Two people had received a single dose and two people had received two doses of JYNNEOS prior to their second infection. The number of sexual partners 21 days prior to infection ranged from one to ten for first infection and one to 15 for second infection. Comparisons of severity data were inconclusive due to missing data and low sample size. Conclusions: Previous mpox infection does not confer long-term immunity in all individuals. While rare, reinfection with mpox can occur. Our reinfection rates are likely an underestimate due to undertesting and lack of disease recognition. Clinicians should test for mpox in patients with compatible symptoms despite previous infection. More research is needed to understand the risk factors, need for vaccination post-infection, and clinical outcomes among people who are infected with mpox multiple times.

Poster Abstracts

1093 Sexual Behaviors Among GBMSM Infected With Mpox in California (May 2022 - July 2024) Kayla Saadeh, Sam Schildhauer, Edwin Chojolan, Awa Keinde, Kelsey MacCuish, Jessica Watson, Eric Tang, Kathleen Jacobson, Robert E. Snyder California Department of Public Health, Richmond, CA, USA Background: In August 2022, a state-of-emergency (SOE) was declared in California due to the global mpox outbreak. During the SOE, gay, bisexual, and other men who have sex with men (GBMSM) adopted mpox prevention strategies, which contributed to the reduction in the number of mpox infections from the initial peak in late summer 2022. We used California mpox surveillance data to describe sexual behaviors among people infected with mpox before, during, and after the SOE. Methods: Information related to STI prevention behaviors were elicited from California residents with mpox who identified as GBMSM during routine public health interviews from May 2022 through July 2024. Time periods were defined as pre-SOE (May 12 – July 31, 2022), during SOE (August 1, 2022 – January 31, 2023) and post-SOE (February 1 – July 31, 2024). Characteristics were compared using Pearson’s chi-squared test; Fisher’s exact test was used if <10 people were in a group. When a specific characteristic was unknown, that individual was excluded from that specific sub-analysis. Results: There were 6,384 confirmed mpox infections in California May 2022-July 2024; of those, 4,714 (73.8%) were GBMSM. Pre-SOE, significantly more GBMSM with mpox reported group sex (29.5%, p<.0001), two or more sex partners (66.9%, p<.0001), and meeting partners at bars/clubs, social events/ festivals, or sex clubs/parties (39.2%, p<.0001), compared to 12.8%, 52.4%, and 24.1% during SOE, respectively. Compared to during SOE, a higher proportion of GBMSM post-SOE reported group sex (19.2%, p<.0001), two or more sex partners (60.8%, p=0.003), and meeting partners at bars/clubs, social events/ festivals, or sex clubs/parties (32.6%, p<.0001); however, these proportions still remained significantly lower than pre-SOE (p<.0001, p=.043, and p=.016, respectively). Conclusions: Sexual behaviors among GBMSM with mpox during the SOE differed significantly from behaviors pre- or post-SOE. During the SOE, a lower proportion of GBMSM with mpox engaged in group sex, had two or more partners, and reported meeting partners at bars/clubs, social events/festivals, or sex clubs/parties. Post-SOE, these behaviors, albeit at lower levels, have increased. The ongoing circulation of mpox in California, coupled with use of fewer mpox avoidance strategies, suggest that mpox will pose an ongoing

1092 Mpox Reinfections in California, May 2022 to August 2024

Jessica Watson 1 , Kayla Saadeh 1 , Alyssa Newman 1 , Aaron Cook 1 , Wyatt Hanft 1 , Kelly A. Johnson 2 , Sam Schildhauer 1 , Jill Hacker 1 , Shiffen Getabecha 1 , Alex Espinosa 1 , Kathleen Jacobson 1 , Robert E. Snyder 1 , Eric Tang 1 1 California Department of Public Health, Richmond, CA, USA, 2 University of California San Francisco, San Francisco, CA, USA Background: At the onset of the 2022 global mpox outbreak, infection from monkeypox virus was believed to offer long-term immunity. However, the first mpox reinfection in California was reported to the California Department Public of Health in April 2023. We sought to identify the frequency of mpox reinfections and associated characteristics to develop clinical and public health guidance to mitigate mpox morbidity. Methods: We reviewed all mpox cases in California reported via public health surveillance from May 2022 to August 2024 and identified possible mpox reinfection among persons with two positive PCR results separated by >60 days. All possible reinfections underwent medical chart review to verify symptom resolution between test results and were classified as suspect, probable, or confirmed per the Centers for Disease Control and Prevention case definition. Specimens from both episodes of mpox infection were sought to conduct genetic sequencing to confirm reinfection. Epidemiological descriptive analyses were done using R software. Results: Out of 6476 reported mpox cases, 9 confirmed/probable mpox reinfections were identified (0.14%). Only one case had samples available from both infections and whole genome sequencing confirmed reinfection in this case (Figure 1). All 9 reinfection cases were cis-gender male and gay, bisexual, or other men who have sex with men. These people ranged in age from 26 to

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