Abstract
BACKGROUND: The increasing incidence of sexually transmitted infections (STIs) is a global health concern, but research on proportions of sexually transmitted coinfection in large populations remains limited. This study estimated the proportions of coinfections among various STIs using a health care nationwide claims database. METHODS: This descriptive epidemiologic study analyzed data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan from April 2013 to December 2020. Five STIs were included: syphilis, genital chlamydia (Chlamydia trachomatis), gonococcal infection (Neisseria gonorrhoeae), genital herpes (herpes simplex virus), and genital warts. Coinfection was defined as the presence of multiple STIs, and proportions were calculated for individuals aged 15 to 49 years. RESULTS: Coinfection proportions were higher among individuals aged 15 to 19 and 20 to 29 years across all STIs. From 2017 to 2020, 3.4% to 6.4% of females with gonococcal infections had syphilis, rising to 8.9% to 9.0% among females aged 15 to 19 years. Among males, 5.4% to 6.1% with genital herpes had syphilis. Genital chlamydia occurred with gonorrhea in 33.8% to 38.1% of males and 37.9% to 40.8% of females. Coinfection proportions for syphilis with genital herpes ranged from 2.5% to 3.0% in males, and genital warts with chlamydia ranged from 2.0% to 2.3% in males and 3.1% to 4.1% in females. CONCLUSIONS: The findings underscore the need for targeted STI screening and early diagnosis to manage and reduce coinfections. These results provide actionable insights for clinicians and public health policy makers to strengthen STI prevention and control strategies.