Background: Bacterial STI incidence has been increasing among US gay and bisexual men living with HIV (GBM-LWH). However, little is known regarding bacterial STI-related knowledge and risk perception in this population.

Objective: Our analysis seeks to address this limitation using baseline survey data from a mixed-methods study evaluating a telehealth intervention for bacterial STI screening.

Methods: 75 racially and ethnically diverse GBM-LWH were recruited from April-October 2024 via in-app advertising. Knowledge of gonorrhea, chlamydia, and syphilis was assessed using a 22-item scale, and perceived risk of contracting a bacterial STI in the next year was assessed using a 10-point ruler. Mann-Whitney U tests were conducted to examine associations of these constructs with sociodemographic and behavioral characteristics.

Results: Ages ranged from 23-70 years (mean=44.9; median=42.0), 39 (52.0%) had less than a college degree, and 38 (50.7%) reported a prior bacterial STI. Of the 24 (32.0%) who were partnered, 18 (75.0%) were in non-monogamous relationships. In the past 6 months, 61 (81.3%) had condomless oral, anal, or vaginal sex with ≥3 partners. Bacterial STI-related knowledge ranged from 6-22 (mean=16.2; median=17.0) and was positively associated with higher education (p<0.001) and past-6-month condomless sex with ≥3 partners (p=0.012). Risk perception ranged from 1-10 (mean=4.5; median=4.0) and was positively associated with non-monogamy (p=0.008) and past-6-month condomless sex with ≥3 partners (p=0.003).

Discussion: GBM-LWH in this sample had suboptimal bacterial STI-related knowledge and low risk perception, despite many engaging in high-risk sexual behaviors. Comprehensive efforts are needed to improve bacterial STI prevention, screening, and treatment services.