Sexual Abuse as a Cause of Sexually Transmitted Infections (STI) and Human Immunodeficiency Virus (HIV) in a Bisexual Adolescent Indonesian: A Case Report

Sexual abuse is any non-consensual sexual act or behavior using force, with significant concern in "men who have sex with men" (MSM), and younger individuals. The incidence of sexually transmitted infections (STI) is also prevalent in the cases of sexual abuse in this population, showing the need for comprehensive medical and psychological intervention. This study presents a case of a 15-year-old Indonesian MSM adolescent who experienced three forced sexual intercourse with a mid-thirties male friend 6 months before the consultation. Psychological evaluation showed signs of moderate depression, then the patient reported erythematous macules and collarettes on the palms and soles. These symptoms appeared 1 month before consultation, without associated pain or pruritus. Additionally, moist, skin-colored verrucous papules and plaques were observed in the perianal area, along with a history of unintentional weight loss. The Kinsey score was calculated as three, showing bisexuality. Testing confirmed positive results for both HIV and syphilis, leading to the secondary diagnosis. The patient tested negative for additional STI and was treated with benzathine benzylpenicillin G 2.4 million international unit (IU) and antiretroviral therapy. After one month, the skin lesions improved and the patient was referred to the psychiatric department for psychological treatment. Syphilis and HIV are the predominant infections, showing the critical necessity of administering appropriate medical treatment, such as antiretroviral therapy and comprehensive STI management, with psychological assessment and management to enhance the psychological well-being of sexually abused individuals.