Sexual behavior as a risk factor for <i>T. Gondii </i>infection in HIV patients

The relationship between sexual behavior and Toxoplasma gondii (T. gondii) infection has gained attention following the discovery of the parasite's presence in semen and ejaculate. Certain sexual behaviors, such as the frequency of sexual activity and inconsistent use of condoms during oral or anal sex, can increase the risk of T. gondii infection. This study aims to investigate the relationship between sexual behavior and T. gondii infection in Human Immunodeficiency Virus (HIV) patients. A cross-sectional study was conducted involving 197 HIV patients on Antiretroviral (ARV) therapy from the Jakarta, Bogor, Bekasi, and Depok regions of Indonesia, supported by four foundations. Serological status for T. gondii infection (IgG-positive) was determined using the Enzyme-Linked Immunosorbent Assay (ELISA) method. Demographic and sexual behavior data were collected through a structured questionnaire. The results revealed that risky sexual behavior significantly increased the probability of T. gondii infection with adjusted Prevalence Ratio (aPR): 6.00; 95% Confidence Interval (CI): 3.38–10.64; p < 0.001. Furthermore, sexual behavior models applied to predict T. gondii infection showed sensitivity, specificity, and accuracy rates of 92.25%, 82.4%, and 88.83%, respectively. The study showed that risky sexual behavior, particularly unprotected oral and anal sex, is associated with an increased risk of T. gondii infection in HIV patients. These findings emphasize the need for screening sexual behaviors as part of routine care in HIV management, particularly in stages I and II. Early identification of high-risk behaviors can help to inform treatment decisions and guide public health interventions, including sexual health education and prevention strategies in primary healthcare settings.