In Reply We appreciate the Letter to the Editor by Ting et al in response to our matched cohort study.1 Although propensity score methods to account for confounding in observational cohorts are well recognized, we acknowledge that there are several ways (each with pros and cons) that the scores can be utilized for data analysis. We opted for 1:1 propensity score matching due in part to the transparency it affords when communicating the ultimate result via the McNemar test. Standardized mortality ratios rely on comparison of a study population with the known generalized rate of the outcome of interest. This would be impractical in the case of mpox because there is an incomplete understanding of the natural history of disease in people with HIV.