A prior STI was associated with a significantly higher risk of mpox diagnosis in the unadjusted model (OR: 3.98 (95% CI: 1.12, 7.46), p < 0.0001) and continued to be associated with increased risk of mpox after adjusting for mode of HIV transmission, race/ethnicity, years since DC Cohort enrollment, years since HIV diagnosis, CD4, and engagement in care in the past 12 months (Model #1 aOR: 3.27 (95% CI: 1.64, 6.49), p = 0.001; Model #3 aOR: 3.39 (95% CI: 1.70, 6.75), p = 0.001) [Table 2]. The gene discussed is CD4; the disease is sexually transmitted disease.