Sexually transmitted diseases and HIV co-infection among adult male patients in the 2022 monkeypox outbreak: a systematic review and meta-analysis

Aim. This meta-analysis estimates the prevalence of sexually transmitted diseases (STIs) and HIV infection among male patients diagnosed with Monkeypox during the 2022 outbreak. The study also explores contextual factors associated with higher risk of monkeypox infection. Methods. A systematic review of literature was initially conducted through PubMed/ Medline, Scopus, and Google Scholar to retrieve observational studies describing demographics and medical characteristics of Monkeypox patients affected in the 2022 outbreak. The System for the Unified Management, Assessment, and Review of Information -Joanna Briggs Institute (SUMARI JBI) guidelines was used to conduct the meta-analysis of this review. All data relevant to prevalence of HIV and STIs in male patients diagnosed with Monkeypox were extracted and exported into the JBI SUMARI. To assess point prevalence of HIV and STIs, we used the Freeman-Tukey-type arcsine square root transformation to stabilize the variances of the raw proportions. All estimates were weighted and pooled by the inverse variance using a fixed-effects model. We then used a random model to account for sampling variation and reported heterogeneity in effect size noted across studies in the fixed-effect model. The I2 test statistic and P values were used to measure the heterogeneity between studies. Values of I2 test statistic results were interpreted as follows: low (25%), moderate (50%) and high (75%). Results. Six studies from Spain and the UK met the inclusion criteria. These studies described a total of 541 male patients with monkeypox, 214 of them were positive for HIV and 255 had other STIs. Overall estimated prevalence of HIV and STIs was 40% (95% CI = 0.31%, 0.50%; ᵡ2 = 15) and 43% (95% CI = 25%, 61%; ᵡ2 = 118), respectively. Outcomes indicated moderate to high heterogeneity in the overall analyses. Conclusions. Approximately four in ten male patients affected in the 2022 Monkeypox outbreak had HIV and/or other STIs. Necessary public health measures should target male and female patients who are at risk of Monkeypox infection to prevent the transmission of serious infections such as HIV and other STIs.