Sexually transmitted infections among homosexual and bisexual men who have sex with men: A 9-year retrospective cross-sectional comparative study.

Abstract

Context: The number of men who have sex with men (MSM) seeking health care has increased in recent years, but the research comparing sexually transmitted infections (STI) prevalence and risk behaviors between homosexual and bisexual MSM is limited, particularly postpandemic.

Aims: To compare the profile of STIs and risk behaviors between homosexual and bisexual MSM attending our STI clinic.

Methodology: In this comparative cross-sectional study, we analyzed the records of all male STI patients who reported at least one male partner who attended our STI clinic from January 2015 to December 2023 for demographic details, sexual history, clinical examination, and laboratory findings.

Statistical analysis: Chi-square test and logistic regression were utilized.

Results: The number of MSM attending STI clinics showed a rising trend, with a sharp decline during the pandemic followed by a significant rebound. Bisexuals outnumbered homosexuals until the lockdown, after which the trend reversed. About 42.6% of homosexuals and 26.7% of bisexuals reported first sexual exposure before the age of 16 (odds ratio (OR) = 2.04, 95% confidence interval (CI): 1.17-3.55, P = 0.01). Syphilis was the most prevalent STI (70.6%), followed by HIV (29.8%) and condyloma acuminata (16.6%). Homosexuals had a significantly higher prevalence of syphilis (adjusted OR 4.82, 95% CI 1.94-11.93, P < 0.01) than bisexuals. 51.4% of HIV cases were newly diagnosed on evaluation after attending the STI clinic.

Conclusions: There was a sharp rise in the number of MSM attending the STI clinic, especially homosexuals. Syphilis was the most prevalent STI, particularly among homosexuals, which frequently coexisted with HIV.