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. 2025 Jun 20;17(6):e86459.
doi: 10.7759/cureus.86459. eCollection 2025 Jun.

Risk at the Crossroads: Evaluating the Risk of Sexually Transmitted Infections in High-Risk Groups

Vijaylakshmi Jain  1 , Sumit Aggarwal  2 , Kuldeep Nigam  2 , Bhushan Kamble  1 , Rashmi Kundapur  1 , Deepthi Konda  3 , Mishu Mangla  4 , Raja Sundaramurthy  5 , Meely Panda  1 , Lakshmi Jyothi Tadi  5
Affiliations

Risk at the Crossroads: Evaluating the Risk of Sexually Transmitted Infections in High-Risk Groups

Vijaylakshmi Jain et al. Cureus. .

Abstract

Background: Sexually transmitted infections (STIs) continue to pose a serious public health challenge globally, including in India. With over one million new cases reported annually, inadequate testing and screening remain significant barriers to controlling and ultimately eliminating STI transmission. Men who have sex with men (MSMs), transgender individuals (TGs), female sex workers (FSWs), and injecting drug users (IDUs) are widely recognized as experiencing higher infection rates. In this context, we aimed to evaluate STI-associated risk factors among high-risk group (HRG) communities in Hyderabad.

Methods: A community-based, cross-sectional study was conducted from February 2024 to January 2025 to assess STI risk across high-risk groups, including IDU, MSM, FSW, and TG populations residing in various parts of Hyderabad city. A questionnaire-based STI risk assessment tool, adapted from NACO guidelines, was used in the study. Participants were administered the standardized tool, and pertinent sociodemographic data were collected and analyzed using Jamovi v2.6 software.

Results: The study employed a questionnaire-based tool to identify and address key socio-behavioral risks associated with STI transmission. A significantly high risk of STIs was observed across all typologies, with particularly elevated risk in MSM (87.3%) and TG (69.2%) individuals falling into the medium-to-high risk category. Substantial risk was also noted in FSWs (57.5%) and IDUs (60.7%), primarily under the low-risk category. Factors such as younger age, marital status, and family structure were associated with higher STI risk.

Conclusion: A significantly higher risk of STI was observed among MSM and TG individuals compared to FSWs and IDUs within the overall HRG population. These findings highlight the utility of STI risk screening in targeted intervention sites, NGOs, and healthcare settings. They further emphasize the need for focused interventions and routine STI screening, particularly among high-risk groups.

Keywords: high-risk groups; india; reproductive tract infections; risk assessment; sexually transmitted infection.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, All India Institute of Medical Sciences, Bibinagar issued approval AIIMSIBBN/IEC/NOV/2023/342. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Bhushan Kamble declare(s) a grant from Indian Council of Medical Research. This study was supported by ICMR extramural grant letter no. DDR/STICALL/09/9/2023. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Risk categories based on typologies in HRGs (n=342)
MSMs: men who have sex with men, TGs: transgender individuals, FSWs: female sex workers, IDUs: injecting drug users, HRG: high-risk group.
Figure 2
Figure 2. Sexual behavioral methods and risk status among HRGs
MSMs: men who have sex with men, TGs: transgender individuals, FSWs: female sex workers, IDUs: injecting drug users, HRG: high-risk group.
Figure 3
Figure 3. Condom use, breakage, and compromise affecting the risk status of HRGs
HRG: high-risk group.
See this image and copyright information in PMC

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