{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:44:30Z","timestamp":1790729070029,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T00:00:00Z","timestamp":1696982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","award":["PS19-1901"],"award-info":[{"award-number":["PS19-1901"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01-AI14812701"],"award-info":[{"award-number":["R01-AI14812701"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exposures associated with mpox infection remain imperfectly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a case-control study enrolling participants who received molecular tests for mpox\/orthopoxvirus in California from November 2022 through June 2023. We collected data on behaviors during a 21-day risk period before symptom onset or testing among mpox case patients and test-negative controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen of 54 case patients (24.1%) and 5 of 117 controls (4.3%) reported sexual exposure to individuals they identified as potential mpox case patients (\u201cindex contacts\u201d; odds ratio [OR], 7.7 [95% confidence interval (CI), 2.5\u201319.3] relative to individuals who did not report exposure to potential mpox case patients). Among these participants, 10 of 13 case patients (76.9%) and 2 of 5 controls (40.0%) reported that their index contacts were not experiencing symptoms visible to participants during sex (OR, 14.9 [95% CI, 3.6\u2013101.8]). Only 3 of 54 case patients (5.6%) reported exposure to symptomatic index contacts. Case patients reported more anal\/vaginal sex partners than did controls (adjusted OR, 2.2 [95% CI, 1.0\u20134.8] for 2\u20133 partners and 3.8 [1.7\u20138.8] for \u22654 partners). Male case patients with penile lesions more commonly reported insertive anal\/vaginal sex than those without penile lesions (adjusted OR, 9.3 [95% CI, 1.6\u201354.8]). Case patients with anorectal lesions more commonly reported receptive anal sex than those without anorectal lesions (adjusted OR, 14.4 [95% CI, 1.0\u2013207.3]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sexual exposure to contacts known or suspected to have experienced mpox was associated with increased risk of infection, often when index contacts lacked apparent symptoms. Exposure to more sex partners, including those whom participants did not identify as index contacts, was associated with increased risk of infection in a site-specific manner. While participants\u2019 assessment of symptoms in partners may be imperfect, these findings suggest that individuals without visibly prominent mpox symptoms transmit infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiad447","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T13:47:02Z","timestamp":1697032022000},"page":"S188-S196","source":"Crossref","is-referenced-by-count":8,"title":["Sexual Exposures Associated With Mpox Infection: California, November 2022 to June 2023"],"prefix":"10.1093","volume":"229","author":[{"given":"Robert E","family":"Snyder","sequence":"first","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Saadeh","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric C","family":"Tang","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly A","family":"Johnson","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel N","family":"Holland","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"},{"name":"School of Public Health, University of California , Berkeley, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Quint","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole O","family":"Burghardt","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shua J","family":"Chai","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"},{"name":"Career Epidemiology Field Officer Program, Division of State and Local Readiness, Office of Readiness and Response, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshani","family":"Fernando","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly Gonzalez","family":"Barrera","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korie","family":"McManus","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"},{"name":"School of Public Health, University of California , Berkeley, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"},{"name":"School of Public Health, University of California , Berkeley, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarett","family":"Maycott","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"},{"name":"School of Public Health, University of California , Berkeley, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McGinley","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Diseases Control Branch, California Department of Public Health , Richmond and Sacramento, California , USA"},{"name":"School of Public Health, University of California , Berkeley, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A","family":"Lewnard","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California , Berkeley, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"key":"2024032619381623300_jiad447-B1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S0140-6736(22)02075-X","article-title":"Monkeypox","volume":"401","author":"Mitj\u00e0","year":"2023","journal-title":"Lancet"},{"key":"2024032619381623300_jiad447-B2","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1056\/NEJMra2208860","article-title":"Monkeypox","volume":"387","author":"Gessain","year":"2022","journal-title":"New Engl J Med"},{"key":"2024032619381623300_jiad447-B3","doi-asserted-by":"crossref","first-page":"428","DOI":"10.4269\/ajtmh.2005.73.428","article-title":"Extended interhuman transmission of monkeypox in a hospital community in the Republic of the Congo, 2003","volume":"73","author":"Bolanda","year":"2005","journal-title":"Am J Trop Med 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