Examining the Prevalence and Associated Factors of Sexually Transmitted Infections in People Living with HIV/AIDS at a Community Health Center in Bandung City, Indonesia [Letter]

Dear editor

I have read a research article entitled ” Examining the Prevalence and Associated Factors of Sexually Transmitted Infections in People Living With HIV/AIDS at a Community Health Center in Bandung City, Indonesia. I would like to congratulate the author on this successful article, and make a contribution.¹ This research provides valuable insight into prevalence of sexual transmitted infections (STIs) in People Living With HIV/AIDS (PLWHA) and risk factors associated with STIs in PLWHA. The findings highlight the importance of prevalence of sexual transmitted infections (STIs) in People Living With HIV/AIDS (PLWHA) and risk factors associated with STIs in PLWHA at a Community Health Center in Bandung City, Indonesia.

Although this research has advantages, this research also has several limitations that need to be considered in the future research other than those presented by researchers in this journal. 1) This study only uses data from medical records of certain health centers, so the result of this research is difficult to generalize in the broader population.^2,3 2) This study did not allow for the examination of other factors that may influence the prevalence of STIs in PLWHA, such as psychosocial factors, sexual behavior, stigma, social, and support. Psychosocial factors such as mental health can affect People Living With HIV/AIDS (PLWHA) to avoid STIs. PLWHA often experience mental health problems such as depression, anxiety, and stress. Poor mental health can make PLWHA ignore risk factors that can affect their health, such as having unprotected sex, which increases the risk of STIs. In addition, poor mental health can cause PLWHA to become desperate so that they ignore HIV/AIDS treatment, such as antiretroviral therapy (ARV) or ignore STI tests, which increase the risk of STIs.^4,5 Bad sexual behaviour can increase the risk of STIs in PLWHA. Sexual behaviour such as changing partners and not using protection (condoms) can increase a person’s risk of contracting STIs.^4,5 Social support can influence PLWHA to avoid STIs because good social support can increase treatment adherence and reduce risky behaviour, and vice versa. Social support received by PLWHA from family, friends, or the community can help them be more disciplined in undergoing treatment routinely and on time, helping to suppress the HIV viral load and keep the immune system strong so that it can prevent STIs.⁵ Stigma in PLWHA can affect their health, including the emergence of STIs. PLWHA who are stigmatized will be influenced not to seek treatment or medical examination because they are afraid of being judged or labelled badly by society, so they may not follow HIV treatment.⁴