Coinfection and repeat bacterial sexually transmitted infections (STI) – retrospective study on male attendees of public STI clinics in an Asia Pacific city

Without protective immunity, recurrent sexually transmitted infections (STI) could occur. In this study, we retrospectively collected STI diagnosis records from public STI clinics attended by an average of 6,000 male patients annually in Hong Kong in 2009–2019. We estimated the prevalence of three bacterial STI (syphilis, chlamydia and gonorrhoea) coinfection from 2009 to 2019, and examined the factors associated with coinfection in 2014/15 and repeat infection in 2009–2019. We observed an increasing coinfection prevalence in male attendees with bacterial STI over the years, which reached the highest level of 15% in 2019. Among 3,698 male patients in 2014–2015, chlamydia/gonorrhoea coinfection was the commonest among all coinfections (77%). Factors such as young age (29 or below), HIV-positive status, and a history of concurrent genital warts/herpes were positively associated with coinfection in 2014/15 in multivariable logistic regression. Of all male patients with STI coinfection in 2014/15, those of age 30–49 and who self-reported as men who have sex with men (MSM) were more likely to have been repeatedly infected in 2009–2019. The results support the implementation of regular multi-STI testing as an STI control strategy for selected communities like MSM and people living with HIV.