Uncovering the Risk of Sexually Transmitted Infections in Men Who Have Sex with Men (MSM) in Indonesia
,
Abstract
Background: The prevalence of sexually transmitted infections in men who have sex with men (MSM) is higher than in other communities. We aimed to Uncovering the risk of sexually transmitted infections in MSM in Indonesia.
Methods: We adopted a cross-sectional design carried out in 24 provinces in Indonesia from March-May 2023, using secondary data from the 2018-2019 Integrated Biological Behavior Survey (IBBS). The population consisted of MSM who had sex with men totaling 6,000 people. A total of 4,290 samples were selected using Respondent Driven Sampling (RDS). The data obtained were analyzed with chi-square and logistic regression models of risk factors.
Results: The prevalence of STIs in MSM was 20.9%. Marital status, consistency of condom use (P<0.01), how to get condoms (P<0.001), and STIs examination (P<0.001) had a significant association with the incidence of STIs among MSM from 2018 – 2019. Meanwhile, the use of lubricant during sex association had no significant relationship with the incidence of STIs. Vaginal and anal sexual intercourse had a significant relationship with the incidence of STIs, where MSM who CI95% (had their first anal sex between the ages of 25-49 years (P<0.001), AOR=2.26 and vaginal sex at the age of ≥50 years were more at risk of experiencing STIs (P<0.017), AOR=1.33.
Conclusion: Marital status, consistency of condom use, how to get condoms, and STIs examination, vaginal and anal sexual intercourse had a significant association with the incidence of STIs among MSM.
1. Prejean J, Song R, Hernandez A, et al (2011). Estimated HIV Incidence in the United States, 2006–2009. Lee V, editor. PLoS One, 6(8):e17502.
2. Machalek DA, Poynten M, Jin F, et al (2012). Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis. Lancet Oncol, 13(5):487–500.
3. Koblin BA, Husnik MJ, Colfax G, et al (2006). Risk factors for HIV infection among men who have sex with men. AIDS, 20(5):731–739.
4. Mwaniki SW, Kaberia PM, Mugo PM, Palanee-Phillips T (2023). HIV prevalence and associated risk factors among young tertiary student men who have sex with men (MSM) in Nairobi, Kenya: a respondent-driven sampling survey. AIDS Res Ther, 20(1):7.
5. Rossotti R, Nava A, Baiguera C, et al (2022). High prevalence of anal papillomavirus infection in men who have sex with men PrEP users. Sex Transm Infect, sextrans-2022-055447.
6. Koyalta D, Mboumba Bouassa RS, et al (2021). Correction: High Prevalence of Anal Oncogenic Human Papillomavirus Infection in Young Men Who Have Sex with Men Living in Bamako Mali. Infect Agent Cancer, 16(1):51.
7. Pachauri S, Pachauri A, Mittal K (2022). Men Who Have Sex with Men. Springer Briefs in Public Health, 14 (1): 61-76.
8. Palefsky JM, Holly EA, Ralston ML, Jay N (1998). Prevalence and Risk Factors for Human Papillomavirus Infection of the Anal Canal in Human Immunodeficiency Virus (HIV)‐Positive and HIV‐Negative Homosexual Men. J Infect Dis, 177(2):361-7.
9. Damay A, Fabre J, Costes V, et al (2010). Human papillomavirus (HPV) prevalence and type distribution, and HPV-associated cytological abnormalities in anal specimens from men infected with HIV who have sex with men. J Med Virol, 82(4):592–596.
10. Beyrer C, Baral SD, Van Griensven F, et al (2012). Global epidemiology of HIV infection in men who have sex with men. Lancet, 380(9839):367–377.
11. Bouassa RSM, Bélec L, Gubavu C, Péré H, et al (2019). High Prevalence of Anal and Oral High-Risk Human Papillomavirus in Human Immunodeficiency Virus-Uninfected French Men Who Have Sex with Men and Use Preexposure Prophylaxis. Open Forum Infect Dis, 6(9): ofz291.
12. Li X, Li M, Yang Y, et al (2016). Anal HPV/HIV co-infection among Men Who Have Sex with Men: a cross-sectional survey from three cities in China. Sci Rep, 6: 21368.
13. Huang MH, Chen GJ, Sun HY, et al (2023). Risky sexual practices and hepatitis C viremia among HIV-positive men who have sex with men in Taiwan. J Microbiol Immunol Infect, 56(3):566–574.
14. Ross MW. (1992). Men who have sex with men. AIDS Care, 4(4): 457-459
15. Rosenberg ES, Sullivan PS, DiNenno EA, Salazar LF, Sanchez TH (2011). Number of casual male sexual partners and associated factors among men who have sex with men: Results from the National HIV Behavioral Surveillance system. BMC Public Health, 11:189.
16. Marcus U, Veras M, Casabona J, et al (2023). Comparison of the burden of self-reported bacterial sexually transmitted infections among men having sex with men across 68 countries on four continents. BMC Public Health, 23(1):1008.
17. Millett GA, Peterson JL, Flores SA, et al (2012). Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet, 380(9839):341–348.
18. Valleroy LA (2000). HIV Prevalence and Associated Risks in Young Men Who Have Sex With Men. JAMA, 284(2):198-204.
19. Aung ET, Fairley CK, Ong JJ, et al (2023). Incidence and Risk Factors for Early Syphilis Among Men Who Have Sex With Men in Australia, 2013–2019: A Retrospective Cohort Study. Open Forum Infect Dis, 10 (2): ofad017.
20. Kemenkes RI (2019). Survei Terpadu Biologis dan Perilaku (STBP) 2018-2019. Kementerian Kesehatan Republik Indonesia, 5(3):248–53.
21. Keshinie Samarasekara, Miriam Ringshall, Kuhuk Parashar, et al (2022). Contribution of men who have sex with men (MSM) attending due to contact tracing to the diagnoses of HIV, syphilis and gonorrhoea in MSM from a clinic-based population. Sex Transm Infect, 98(4):307-309.
22. Vasilenko SA, Rice CE, Rosenberger JG (2018). Patterns of Sexual Behavior and Sexually Transmitted Infections in Young Men Who Have Sex With Men. Sex Transm Dis, 45(6):387–393.
23. Kent CK, Chaw JK, Wong W, et al (2005). Prevalence of Rectal, Urethral, and Pharyngeal Chlamydia and Gonorrhea Detected in 2 Clinical Settings among Men Who Have Sex with Men: San Francisco, California. Clin Infect Dis, 41(1):67–74.
24. Le Roux M, Ngwenya IK, Nemarude AL, et al (2023). Sexually transmitted infections and sexual behaviour among men having sex with men from Tshwane, South Africa. Int J STD AIDS, 34(3):183–190.
25. Purcell DW, Johnson CH, Lansky A, et al (2012). Estimating the Population Size of Men Who Have Sex with Men in the United States to Obtain HIV and Syphilis Rates. Open AIDS J, 6:98–107.
26. Division of STD Prevention, National Center for HIV (2021). Viral Hepatitis, STD, and TB Prevention for CDC and P. Enteric Infections Among Men Who Have Sex with Men. CDC, https://www.cdc.gov/std/treatment-guidelines/msm.htm
27. Tsai CS, Chen PL, Lee NY, et al (2023). Characteristics of rectal chlamydia among men who have sex with men in southern Taiwan, 2020–2022: An emerging threat of rectal lymphogranuloma venereum L2b. J Microbiol Immunol Infect, 56(2):408–415.
28. Baggaley RF, White RG, Boily MC (2010), HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention. Int J Epidemiol, 39(4):1048–1063.
29. Hernandez I, Reina-Ortiz M, Johnson A, et al (2017). Risk Factors Associated With HIV Among Men Who Have Sex With Men (MSM) in Ecuador. Am J Mens Health, 11(5):1331-1341
30. Morineau G, Nugrahini N, Riono P, et al (2011). Sexual risk taking, STI and HIV prevalence among men who have sex with men in six Indonesian cities. AIDS Behav, 15(5):1033–1044.
31. Peate I (2012). Sexually transmitted infections in men who have sex with men. Br J Nurs, 21(13): 811-815.
32. Gleason N, Smith G, Canning JR, et al (2023). The Relationship Between Alcohol and Drug Use, Compulsive Sexual Behavior, and Condomless Anal Sex in Men Who have Sex with Men: Analysis of Retrospectively-Reported Sexual Behavior. AIDS Behav, 27(7):2317–2327.
33. Koblin BA, Chesney MA, Husnik MJ, et al (2003). High-Risk Behaviors Among Men Who Have Sex With Men in 6 US Cities: Baseline Data From the EXPLORE Study. Am J Public Health, 93(6):926–932.
34. Stall R, Paul JP, Greenwood G, et al (2001). Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men’s Health Study. Addiction, 96(11):1589–601.
35. Smith MK, Graham M, Harripersaud K, et al (2023). Sexual mixing patterns in men who have sex with men: network approaches for smart resource allocation. Sex Health, 20(2):126-133.
36. Yu M, Song D, Zhang T, et al (2022). High risks of HIV transmission for men sex worker — a comparison of profile and risk factors of HIV infection between MSM and MSW in China. BMC Public Health, 22(1): 858
37. de Jesus Salgado V, de Abreu Oliveira CMP, da Silva ÁMB, et al (2023). Prevalence of Mollicutes among men who have sex with men and transgender women aged 15 to 19 years in Salvador, North-eastern Brazil. BMC Infect Dis, 23(1):244.
38. Sentís A, Martin-Sanchez M, Arando M, et al (2019). Sexually transmitted infections in young people and factors associated with HIV coinfection: An observational study in a large city. BMJ Open, 9(5): e027245.
39. Pufall EL, Kall M, Shahmanesh M, et al (2018). Sexualized drug use (‘chemsex’) and high-risk sexual behaviours in HIV-positive men who have sex with men. HIV Med, 19(4):261–270.
40. Motta-Castro ARC, Kerr L, Kendall C, et al (2023). Hepatitis B Prevalence among Men Who Have Sex with Men in Brazil. Trop Med Infect Dis, 8(4):218.
41. Sullivan PS, Carballo-Diéguez A, Coates T, et al (2012). Successes and challenges of HIV prevention in men who have sex with men. Lancet, 380(9839):388–399.
42. Marcus U, Jonas K, Berg R, et al (2023). Association of internalised homonegativity with partner notification after diagnosis of syphilis or gonorrhoea among men having sex with men in 49 countries across four continents. BMC Public Health, 23(1):8.
2. Machalek DA, Poynten M, Jin F, et al (2012). Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis. Lancet Oncol, 13(5):487–500.
3. Koblin BA, Husnik MJ, Colfax G, et al (2006). Risk factors for HIV infection among men who have sex with men. AIDS, 20(5):731–739.
4. Mwaniki SW, Kaberia PM, Mugo PM, Palanee-Phillips T (2023). HIV prevalence and associated risk factors among young tertiary student men who have sex with men (MSM) in Nairobi, Kenya: a respondent-driven sampling survey. AIDS Res Ther, 20(1):7.
5. Rossotti R, Nava A, Baiguera C, et al (2022). High prevalence of anal papillomavirus infection in men who have sex with men PrEP users. Sex Transm Infect, sextrans-2022-055447.
6. Koyalta D, Mboumba Bouassa RS, et al (2021). Correction: High Prevalence of Anal Oncogenic Human Papillomavirus Infection in Young Men Who Have Sex with Men Living in Bamako Mali. Infect Agent Cancer, 16(1):51.
7. Pachauri S, Pachauri A, Mittal K (2022). Men Who Have Sex with Men. Springer Briefs in Public Health, 14 (1): 61-76.
8. Palefsky JM, Holly EA, Ralston ML, Jay N (1998). Prevalence and Risk Factors for Human Papillomavirus Infection of the Anal Canal in Human Immunodeficiency Virus (HIV)‐Positive and HIV‐Negative Homosexual Men. J Infect Dis, 177(2):361-7.
9. Damay A, Fabre J, Costes V, et al (2010). Human papillomavirus (HPV) prevalence and type distribution, and HPV-associated cytological abnormalities in anal specimens from men infected with HIV who have sex with men. J Med Virol, 82(4):592–596.
10. Beyrer C, Baral SD, Van Griensven F, et al (2012). Global epidemiology of HIV infection in men who have sex with men. Lancet, 380(9839):367–377.
11. Bouassa RSM, Bélec L, Gubavu C, Péré H, et al (2019). High Prevalence of Anal and Oral High-Risk Human Papillomavirus in Human Immunodeficiency Virus-Uninfected French Men Who Have Sex with Men and Use Preexposure Prophylaxis. Open Forum Infect Dis, 6(9): ofz291.
12. Li X, Li M, Yang Y, et al (2016). Anal HPV/HIV co-infection among Men Who Have Sex with Men: a cross-sectional survey from three cities in China. Sci Rep, 6: 21368.
13. Huang MH, Chen GJ, Sun HY, et al (2023). Risky sexual practices and hepatitis C viremia among HIV-positive men who have sex with men in Taiwan. J Microbiol Immunol Infect, 56(3):566–574.
14. Ross MW. (1992). Men who have sex with men. AIDS Care, 4(4): 457-459
15. Rosenberg ES, Sullivan PS, DiNenno EA, Salazar LF, Sanchez TH (2011). Number of casual male sexual partners and associated factors among men who have sex with men: Results from the National HIV Behavioral Surveillance system. BMC Public Health, 11:189.
16. Marcus U, Veras M, Casabona J, et al (2023). Comparison of the burden of self-reported bacterial sexually transmitted infections among men having sex with men across 68 countries on four continents. BMC Public Health, 23(1):1008.
17. Millett GA, Peterson JL, Flores SA, et al (2012). Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet, 380(9839):341–348.
18. Valleroy LA (2000). HIV Prevalence and Associated Risks in Young Men Who Have Sex With Men. JAMA, 284(2):198-204.
19. Aung ET, Fairley CK, Ong JJ, et al (2023). Incidence and Risk Factors for Early Syphilis Among Men Who Have Sex With Men in Australia, 2013–2019: A Retrospective Cohort Study. Open Forum Infect Dis, 10 (2): ofad017.
20. Kemenkes RI (2019). Survei Terpadu Biologis dan Perilaku (STBP) 2018-2019. Kementerian Kesehatan Republik Indonesia, 5(3):248–53.
21. Keshinie Samarasekara, Miriam Ringshall, Kuhuk Parashar, et al (2022). Contribution of men who have sex with men (MSM) attending due to contact tracing to the diagnoses of HIV, syphilis and gonorrhoea in MSM from a clinic-based population. Sex Transm Infect, 98(4):307-309.
22. Vasilenko SA, Rice CE, Rosenberger JG (2018). Patterns of Sexual Behavior and Sexually Transmitted Infections in Young Men Who Have Sex With Men. Sex Transm Dis, 45(6):387–393.
23. Kent CK, Chaw JK, Wong W, et al (2005). Prevalence of Rectal, Urethral, and Pharyngeal Chlamydia and Gonorrhea Detected in 2 Clinical Settings among Men Who Have Sex with Men: San Francisco, California. Clin Infect Dis, 41(1):67–74.
24. Le Roux M, Ngwenya IK, Nemarude AL, et al (2023). Sexually transmitted infections and sexual behaviour among men having sex with men from Tshwane, South Africa. Int J STD AIDS, 34(3):183–190.
25. Purcell DW, Johnson CH, Lansky A, et al (2012). Estimating the Population Size of Men Who Have Sex with Men in the United States to Obtain HIV and Syphilis Rates. Open AIDS J, 6:98–107.
26. Division of STD Prevention, National Center for HIV (2021). Viral Hepatitis, STD, and TB Prevention for CDC and P. Enteric Infections Among Men Who Have Sex with Men. CDC, https://www.cdc.gov/std/treatment-guidelines/msm.htm
27. Tsai CS, Chen PL, Lee NY, et al (2023). Characteristics of rectal chlamydia among men who have sex with men in southern Taiwan, 2020–2022: An emerging threat of rectal lymphogranuloma venereum L2b. J Microbiol Immunol Infect, 56(2):408–415.
28. Baggaley RF, White RG, Boily MC (2010), HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention. Int J Epidemiol, 39(4):1048–1063.
29. Hernandez I, Reina-Ortiz M, Johnson A, et al (2017). Risk Factors Associated With HIV Among Men Who Have Sex With Men (MSM) in Ecuador. Am J Mens Health, 11(5):1331-1341
30. Morineau G, Nugrahini N, Riono P, et al (2011). Sexual risk taking, STI and HIV prevalence among men who have sex with men in six Indonesian cities. AIDS Behav, 15(5):1033–1044.
31. Peate I (2012). Sexually transmitted infections in men who have sex with men. Br J Nurs, 21(13): 811-815.
32. Gleason N, Smith G, Canning JR, et al (2023). The Relationship Between Alcohol and Drug Use, Compulsive Sexual Behavior, and Condomless Anal Sex in Men Who have Sex with Men: Analysis of Retrospectively-Reported Sexual Behavior. AIDS Behav, 27(7):2317–2327.
33. Koblin BA, Chesney MA, Husnik MJ, et al (2003). High-Risk Behaviors Among Men Who Have Sex With Men in 6 US Cities: Baseline Data From the EXPLORE Study. Am J Public Health, 93(6):926–932.
34. Stall R, Paul JP, Greenwood G, et al (2001). Alcohol use, drug use and alcohol-related problems among men who have sex with men: the Urban Men’s Health Study. Addiction, 96(11):1589–601.
35. Smith MK, Graham M, Harripersaud K, et al (2023). Sexual mixing patterns in men who have sex with men: network approaches for smart resource allocation. Sex Health, 20(2):126-133.
36. Yu M, Song D, Zhang T, et al (2022). High risks of HIV transmission for men sex worker — a comparison of profile and risk factors of HIV infection between MSM and MSW in China. BMC Public Health, 22(1): 858
37. de Jesus Salgado V, de Abreu Oliveira CMP, da Silva ÁMB, et al (2023). Prevalence of Mollicutes among men who have sex with men and transgender women aged 15 to 19 years in Salvador, North-eastern Brazil. BMC Infect Dis, 23(1):244.
38. Sentís A, Martin-Sanchez M, Arando M, et al (2019). Sexually transmitted infections in young people and factors associated with HIV coinfection: An observational study in a large city. BMJ Open, 9(5): e027245.
39. Pufall EL, Kall M, Shahmanesh M, et al (2018). Sexualized drug use (‘chemsex’) and high-risk sexual behaviours in HIV-positive men who have sex with men. HIV Med, 19(4):261–270.
40. Motta-Castro ARC, Kerr L, Kendall C, et al (2023). Hepatitis B Prevalence among Men Who Have Sex with Men in Brazil. Trop Med Infect Dis, 8(4):218.
41. Sullivan PS, Carballo-Diéguez A, Coates T, et al (2012). Successes and challenges of HIV prevention in men who have sex with men. Lancet, 380(9839):388–399.
42. Marcus U, Jonas K, Berg R, et al (2023). Association of internalised homonegativity with partner notification after diagnosis of syphilis or gonorrhoea among men having sex with men in 49 countries across four continents. BMC Public Health, 23(1):8.
| Files | ||
| Issue | Vol 54 No 3 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Men Sexually transmitted infections (STIs) Sex intercourse Indonesia | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Hasmi H, Safitri Fatiah M, Muttaqin MZ. Uncovering the Risk of Sexually Transmitted Infections in Men Who Have Sex with Men (MSM) in Indonesia. Iran J Public Health. 2025;54(3):615-623.
