Clinical and behavioral determinants of oral lesions among people living with HIV/AIDS in West Java, Indonesia: a cross-sectional study

Background Oral lesions remain common among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may serve as important clinical indicators of immune status and disease progression, particularly in resource-limited settings. However, data from Indonesia remains limited. This hospital-based cross-sectional study aimed to characterise the spectrum of oral lesions and identify clinical and behavioral determinants associated with their occurrence among people living with HIV/AIDS (PLWHA) attending a tertiary referral hospital in West Java, Indonesia. Methods A total of 254 PLWHA were enrolled. Sociodemographic, behavioral, and clinical data were collected through interviews and medical records, and comprehensive intraoral examinations were performed by an oral medicine specialist. Multivariable logistic regression analyses were used to identify independent determinants of oral lesions. Results Oral lesions were identified in 75.6% of participants, with acute pseudomembranous candidiasis (27.2%), oral hairy leukoplakia (20.1%), and recurrent aphthous stomatitis (15.1%) being the most frequent diagnoses. Significant determinants of oral lesions included age ≥ 46 years (AOR 7.71; 95% CI: 1.38–43.21), underweight body mass index (AOR 4.14; 95% CI: 1.63–10.53), poor oral hygiene (AOR 4.43; 95% CI: 1.06–18.44), smoking (AOR 3.26; 95% CI: 1.51–7.08), and advanced HIV clinical stage (AOR 3.69; 95% CI: 1.71–7.95). Conclusions Clinical and behavioral factors play an important role in the development of oral lesions among PLWHA, underscoring the importance of integrating routine oral examinations and targeted oral health strategies into HIV care, particularly in settings with limited access to health care.