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The epidemiological risk factors associated with mpox acquisition and severity in the Democratic Republic of the Congo (DRC) are changing. We assessed perceived mpox risk, and behavioral, clinical and sexual histories among key populations at risk of acquisition through sexual contact. Here, we describe a sampling strategy to enroll participants considered to be at increased risk for mpox infection - men who have sex with men (MSM) and sex workers (SW) - in three urban centers in the DRC. Through the combined approach of time-location sampling with peer educators and respondent-driven sampling, a mixed cohort of 2826 individuals including self-identified MSM (n = 850), SW (n = 815), both MSM and SW (n = 118) and non-MSM, non-SW individuals (n = 1043) were enrolled in Kinshasa, Kinshasa province, Kenge, Kwango province, and Goma, North Kivu province, from March-August 2024. Of these, over 90% were reached through peer educators. The odds of sampling SW individuals were higher at bars/clubs than traditional health facilities. Conversely, the odds of enrolling MSM were highest at selected health facilities. Modifications to the sampling approach were introduced in Kenge and Goma, but these did not affect the enrollment of MSM or SW participants. Ultimately, the selection of, and collaboration with, well-integrated peer educators was the most important facet of this sampling strategy. As the definitions of at-risk populations continue to change for mpox, we demonstrate a functional approach to quickly surveying otherwise hard-to-reach groups for both public health surveillance activities and response.

刚果民主共和国（Democratic Republic of the Congo, DRC）境内与猴痘（mpox）感染及重症相关的流行病学风险因素正在发生变化。本研究针对通过性接触存在猴痘感染风险的关键人群，评估了其对猴痘的感知风险、行为史、临床史与性行为史。
本研究描述了一套针对刚果民主共和国三座城市中心的猴痘感染高风险参与者的招募抽样策略，该类人群包括男男性行为者（men who have sex with men, MSM）与性工作者（sex workers, SW）。研究结合同伴教育者（peer educators）参与的时间-地点抽样法（time-location sampling）与应答者驱动抽样法（respondent-driven sampling），于2024年3月至8月间，在金沙萨（金沙萨省）、肯格（宽果省）与戈马（北基伍省）三座城市中心招募了2826名混合队列参与者，其中包括自我认定为男男性行为者（n=850）、性工作者（n=815）、同时属于两类人群者（n=118）以及非男男性行为者、非性工作者人群（n=1043）。
其中超过90%的参与者是通过同伴教育者招募的。相较于传统医疗卫生机构，在酒吧与俱乐部招募性工作者的比值比更高；反之，在选定的医疗卫生机构招募男男性行为者的比值比最高。
研究团队在肯格与戈马两地对抽样方法进行了调整，但该调整并未影响男男性行为者与性工作者的招募。最终，精心甄选并紧密协作的同伴教育者，成为本抽样策略中最为关键的环节。
随着猴痘高危人群的定义持续更新，本研究展示了一种可快速调查难以触及人群的实用方法，可用于公共卫生监测与应急响应工作。