Prevalence, co-occurrence patterns, and factors associated with multiple sexually transmitted infections among men living with HIV in Indonesia: A cross-sectional study in Surakarta

Abstract

Men living with human immunodeficiency virus (HIV) may experience a substantial burden of sexually transmitted infections (STIs), including concurrent infections. The aim of this study was to determine the prevalence and co-occurrence patterns of multiple STIs and identify factors associated with their occurrence among male patients living with HIV. A retrospective cross-sectional study was conducted using medical records of 70 male patients living with HIV who were diagnosed with at least one active STI at Dr. Moewardi Regional General Hospital, Surakarta, Indonesia, between January 2019 and December 2023. Demographic characteristics, sexual orientation, number of sexual partners, and STI diagnoses were analyzed using bivariate analysis and multivariable binary logistic regression. Multiple STIs were identified in 18.6% of participants. Condyloma acuminata was the most frequently documented single STI (50.0%), while condyloma acuminata with syphilis was the predominant multiple-STI combination (14.3%). In the bivariate analysis, sexual orientation (p=0.005) and number of sexual partners (p=0.003) were significantly associated with multiple STIs, whereas age and education level were not. After adjustment, having more than one sexual partner remained significantly associated with multiple STIs (OR=6.93; 95%CI: 1.20–39.95; p=0.030), while sexual orientation was not significantly associated in the overall multivariable model (p=0.165). These findings support comprehensive STI screening and careful assessment of sexual behavior among men living with HIV, particularly those reporting multiple sexual partners.