(P220) Understanding the Impact of Mpox on Sexual Health Clinical Services: A National Knowledge, Attitudes, and Practices Survey – United States, 2022

Background
During the 2022 mpox outbreak, nearly all cases have been associated with sexual contact, and many people have presented or were referred to sexually transmitted disease (STD) clinics with anogenital mpox lesions. Additionally, many people at highest risk of mpox were already users of STD clinics. The National Network of STD Clinical Prevention Training Centers (NNPTCs), in partnership with Centers for Disease Control and Prevention (CDC), conducted a survey to understand the impact of the mpox outbreak on sexual health programs. The purpose of the survey was to assess knowledge, practices, and experiences around mpox vaccines, testing, and management to inform public health response efforts, including resource and training development. To our knowledge, this is the most comprehensive nation-wide mpox-related survey of sexual health programs in the United States.

Methods
During August 31–September 13, 2022, the eight regional STD training centers facilitated a cross-sectional, web-based survey administered via the Enketo platform. The survey requested a single respondent per clinical site. A cross-sectional descriptive data analysis was then performed.

Results
There were 168 survey responses by clinicians (n=131, 78%) and program staff (n=37, 22%). More than half (58%) reported at least somewhat significant mpox-related clinical disruptions. 72% indicated average mpox-related visits lasted >30 minutes, and 22% reported visits lasted ≥one hour. Clinicians reported barriers to mpox testing (82%) and tecovirimat use (42%), and challenges differentiating mpox from other etiologies. Less than half (49%) felt comfortable with mpox pain management and roughly one-third felt uninformed about mpox pre- and post-exposure prophylaxis (29%, 35% respectively).

Of those involved in mpox vaccination, 61% reported using equity strategies. When asked to describe these strategies, respondents often described guideline or risk factor-based screenings instead of equity activities.

Conclusion

These findings highlight the substantial impact of the 2022 mpox outbreak on sexual health programs in the United States. Critical gaps and barriers are identified that may guide additional mpox training and technical assistance. Specifically, clinicians reported challenges with mpox testing, diagnosis, patient counseling, and management. Further, results suggest a knowledge deficit about implementing mpox vaccine programs with attention to equity, indicating an additional area for education.