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Predictors of mpox diagnosis, vaccination, and outcomes among PWH are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included PWH with primary care visits after 1 January 2022 at 9 US sites participating in the Centers for AIDS Research Network of Integrated Clinic Systems Network. We identified mpox diagnosed between 1 June 2022 and 31 May 2023, through a combination of polymerase chain reaction result, diagnosis code, and\/or tecovirimat receipt. We examined validated clinical diagnoses, laboratory results, vaccine data, and patient reported outcomes. We evaluated relative risks (RR) of mpox diagnosis, hospitalization, tecovirimat treatment, and vaccine receipt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Among 19 777 PWH in care, 413 mpox cases (all male sex at birth) occurred (2.2 cases\/100 person-years). Age &amp;lt;40 years, geographic region, Hispanic\/Latine ethnicity, lack of antiretroviral therapy, detectable HIV viral load, and recent bacterial sexually transmitted infection predicted mpox diagnosis. PWH with CD4 200\u2013349\u2005cells\/mm3 were most likely to be hospitalized (adjusted RR, 3.20; 95% confidence interval: 1.44\u20137.09) compared to CD4 \u2265500, but half as likely as those with CD4 &amp;lt;200 to receive tecovirimat. Overall, smallpox\/mpox vaccine effectiveness of \u22651 vaccine was 71% (adjusted RR, 0.29; 95% confidence interval: .14\u2013.47) at preventing mpox, and 86% or better with CD4 \u2265350 or HIV viral suppression. Non-Hispanic Black PWH were less likely to be vaccinated than other racial\/ethnic identities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>PWH not on antiretroviral therapy or with unsuppressed HIV were more likely to be diagnosed with, and hospitalized for, mpox. Mpox\/smallpox vaccine effectiveness was high, inclusive of those with low CD4 count and HIV viremia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciae464","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T23:26:57Z","timestamp":1726270017000},"page":"162-172","source":"Crossref","is-referenced-by-count":16,"title":["Mpox in People With HIV: Predictors of Diagnosis, Outcomes, and Vaccine Effectiveness in a Multisite Cohort"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2872-1929","authenticated-orcid":false,"given":"Michalina","family":"Monta\u00f1o","sequence":"first","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3106-1258","authenticated-orcid":false,"given":"Adrienne 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7192-6075","authenticated-orcid":false,"given":"Laura","family":"Bamford","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Public Health, University of California San Diego , San Diego, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7185-3025","authenticated-orcid":false,"given":"Greer","family":"Burkholder","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2452-7558","authenticated-orcid":false,"given":"Edward R","family":"Cachay","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Public Health, University of California San Diego , San Diego, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8598-2191","authenticated-orcid":false,"given":"Katerina A","family":"Christopoulos","sequence":"additional","affiliation":[{"name":"Division of HIV, ID, and Global Medicine, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3308-7005","authenticated-orcid":false,"given":"Heidi M","family":"Crane","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-1776","authenticated-orcid":false,"given":"Joseph A 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