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Behavioral & Social Science

Category: Mpox

(P198) Impact of 2022 Mpox Outbreak on sexual practices of bathhouse clientele

Tuesday, July 25, 2023
16:00 – 18:00 CST


Background: The 2022 Multi-National Mpox Outbreak disproportionately affected men who have sex with men (MSM), but there is limited data on how sexual practices were impacted. Evolving from a collaboration established during the COVID-19 pandemic, we examined associations between self-reported Mpox history with current and anticipated changes to sexual practices of patrons of Steamworks, a bathhouse and collective sex venue with US and Canadian locations.



Methods: An anonymous, web-based survey was sent to the Steamworks newsletter list-serve to assess demographics, self-reported mpox exposure/infection history, and current and anticipated changes to sexual practices. Adjusted prevalence rate ratios (aPRR) were calculated using multivariable Poisson regression with robust variance to examine factors associated with mpox exposure.





Results: From September 20 through October 22, 2022, 230 surveys were completed. Overall, 14.8% and 5.1% of reported mpox exposure and mpox infection respectively; 74% reported receiving mpox vaccination. Latinx ethnicity, age >40, 4-year college degree, self-reported STI positivity in the past 3 months, and agreeing that reducing number of sex partners can prevent mpox were all associated with increased mpox exposure. Mpox history was not associated with race, gender, or HIV status. Mpox exposure was higher in those who found sex partners through dating apps, bars, house parties, and cruising areas. Regarding anticipated sexual practices, 52% of respondents intended to meet more sex partners in the subsequent 3 months. Those who did not intend to meet more sex partners were less likely to report mpox exposure. In adjusted analyses, age (aPRRs 4.20 – 5.71 for age groups < 50), STI positivity (aPRR=3.69), and agreeing that reducing number of sex partners is an effective way to prevent mpox (aPRR=0.36) remained associated with mpox exposure.





Conclusions: Mpox exposure was significantly associated with changes in respondents’ sexual behaviors. These changes in combination with vaccine uptake may explain the rapid decline and sustained nadir of new mpox cases. The ongoing collaboration between Steamworks and Chicago Department of Public Health helped adapt city-wide sexual health services in real-time during this pivotal public health period (including mpox vaccine rollout), laying a foundation for responses to future public health threats to MSM communities.