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

## TL;DR

This study evaluates STI risk among high-risk groups in Hyderabad and finds that MSM and TG individuals face the highest risk.

## Contribution

The study introduces a questionnaire-based STI risk assessment tool adapted from NACO guidelines for use in community settings.

## Key findings

- MSM and TG individuals showed significantly higher STI risk compared to FSWs and IDUs.
- Younger age, marital status, and family structure were linked to increased STI risk.
- Routine STI screening is emphasized for high-risk groups to improve public health outcomes.

## 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.