Women Who Have Sex With Women And Men Research Articles

Identifying risk factors for sexually transmitted infections and enhancing testing among sexual minority women in China: a national cross-sectional study

ABSTRACT Evidence showed a greater risk of sexually transmitted infections (STIs) among sexual minority women (SMW). Limited studies investigated characteristics and sexual health among Chinese SMW. To fill the current gaps, the research group launched the first national survey to explore sexual behavior and health outcomes among SMW in China. The study recruited participants online during Nov. 1–15, 2020, and disseminated online questionnaires to harvest participants’ sexual behaviors and self-reported STIs in the past year. All the participants read and signed an online informed consent form. Adjusted odds ratio (AOR) and 95 percent confidence intervals (CIs) were calculated in the analysis. Sex toy use (AOR = 1.5; 95 percent CI: 1.3, 1.7), G-spot exploration (AOR = 1.5; 95 percent CI: 1.2, 1.7), symptoms in the past year (AOR = 3.8; 95 percent CI: 3.1, 4.6), and self-reported STIs (AOR = 2.0; 95 percent CI: 1.6, 2.7) were associated with symptoms during sex. Factors associated with self-reported STIs were having first-time sex with a male (AOR = 2.0; 95 percent CI: 1.5, 2.5), digital-vaginal contact (AOR = 2.3; 95 percent CI: 1.1, 4.5), sexual intercourse with a male in the past year (AOR = 1.8; 95 percent CI: 1.2, 2.5), symptoms during sex (AOR = 2.0; 95 percent CI: 1.5, 2.6), and symptoms in the past year (AOR = 6.1; 95 percent CI: 4.8, 7.8). SMW reported risk behaviors for STIs, and women who have sex with women and men (WSW/M) were more susceptible to the infections. Tailored interventions should be developed to raise awareness of STIs and increase STI testing uptake.

Norwegian Data on Prevalence, Sexual Risk Behaviors, Sexual Problems, and Sexual Satisfaction in Women Who Have Sex Exclusively with Women, Women Who Have Sex Exclusively with Men, and Women Who Have Sex with Men and Women

Objective The study explores the difference between Women Who Have Sex Exclusively with Men (WSEM), Women Who Have Sex Exclusively with Women (WSEW), and Women Who Have Sex with Women and Men (WSWM). Method The data were obtained from a survey of a probability-based web sample of 1967 Norwegian women. Results Most WSWM identified themselves as heterosexuals (76.3%), and three out of 10 used a condom when having sex with a new partner. The highest number of sex partners during the last year was reported by WSWM. More WSEW than the other categories reported premature orgasm. Conclusions WSWM should be targeted in health campaigns.

Women who have sex with women (WSW) and women who have sex with women and men (WSWM) in the HIV-AIDS prevention campaigns

Women who have sex with women (WSW) and women who have sex with women and men (WSWM) receive less medical attention than the rest of the population [1]. It is due to structural factors (such as socio-economic and political context, social structure), negative attitudes of professionals, and a lack of published data about the health problems that affect these women

Cervical screening attendance and cervical cancer risk among women who have sex with women.

ObjectivesTo describe cervical cancer screening participation among women who have sex exclusively with women (WSEW) and women who have sex with women and men (WSWM) compared with women who have sex exclusively with men (WSEM), and women who have never had sex and compare this with bowel (colorectal) and breast screening participation. To explore whether there is evidence of differential stage 3 cervical intraepithelial neoplasia (CIN3) or cervical cancer risk.MethodsWe describe cervical, bowel and breast cancer screening uptake in age groups eligible for the national screening programmes, prevalent CIN3 and cervical cancer at baseline, and incident CIN3 and cervical cancer at five years follow-up, among 218,674 women in UK Biobank, a cohort of healthy volunteers from the UK.ResultsCompared with WSEM, in adjusted analysis [odds ratio (95% confidence interval)], WSEW 0.10 (0.08–0.13), WSWM 0.73 (0.58–0.91), and women who have never had sex 0.02 (0.01–0.02) were less likely to report ever having attended cervical screening. There were no differences when considering bowel cancer screening uptake (p = 0.61). For breast cancer screening, attendance was lower among WSWM 0.79 (0.68 to 0.91) and women who have never had sex 0.47 (0.29–0.58), compared with WSEM. There were incident and prevalent cases of both CIN3 and cervical cancer among WSEW and WSWM. Compared with WSEM with a single male partner, among WSEW there was a twofold increase in CIN3 1.91 (1.01 to 3.59); among WSWM with only one male partner, this was 2.25 (1.19 to 4.24).ConclusionsThese findings highlight the importance of improving uptake of cervical screening among all women who have sex with women and breast screening among WSWM and women who have never had sex.

Impact of social factors and sexual behaviors on the knowledge of sexually transmitted infections among women who have sex with women/women who have sex with women and men

Although heterosexual individuals' knowledge of sexually transmitted infections (STIs) has been examined, no studies have been conducted in Poland of the STI knowledge in women who have sex with women (WSW) and women who have sex with women and men (WSWM). We enrolled a group of 146 WSW and 113 WSWM and asked them to complete a study questionnaire that contained items about socioeconomic factors, sexual behaviors, and STI knowledge. The level of STI knowledge among the studied WSW was insufficient. The frequency of correct answers was higher in WSWM. A multivariate regression model revealed that only the higher importance of sex to the respondents ( F(1) = 4.31, p = 0.04) and a higher number of same-sex sexual partners within the last 12 months ( F(1) = 14.86, p = 0.0001) influenced the level of STI knowledge. The results of the study allowed us to conclude that WSW have insufficient STI knowledge, whereas WSWM have better knowledge, and this is influenced by awareness that STI risk is not associated with the partner's gender, age, importance of sex, sexual behaviors, and openness to discussing STIs with a sexual partner.

Description of Sexual Orientation and Sexual Behaviors among High School Girls in New York City

Study ObjectiveExamination of the association of sexual orientation to the sexual practices and health behaviors of high school girls in New York City (NYC). Design, Setting, and ParticipantsData were drawn from the 2013 Youth Risk Behavior Surveillance System survey of public high school students in grades 9-12 in NYC. InterventionsNone. Main Outcome MeasuresIndependent variables included sexual orientation and gender of sexual partners. Dependent variables include sexual/health risk behaviors. We used t tests to compare mean ages and χ2 tests to compare distributions according to sexual orientation, gender of sexual partners, and differences in risk behaviors. ResultsThe survey was completed by 4643 girls; mean age, 15.5 years; (1103 + 1842)/4254 (69%) black or Latina; 1101/4000 (27.5%) sexually active; 3574/4412 (81%) heterosexual; and (92 + 526)/4412 (14%) sexual minorities; 24.1% were heterosexual, 52.1% lesbian, and 49.4% were bisexual girls and were sexually active; 247 were classified as women who have sex with women (WSW) or WSW and men (WSWM). Of the sexually active girls, (65 + 182)/1081 (23%) were WSW/WSWM. The WSW/WSWM reported earlier sexual debut, more sexual partners, higher pregnancy rate, use of alcohol at last sex, history of intimate partner violence, and less likelihood of having an HIV test. ConclusionAlmost one in four of sexually active high school girls in NYC can be classified as WSW, who are vulnerable to increased sexual and health risk-taking behaviors leading to adverse health outcomes. The discordance between sexual behavior and sexual orientation emphasizes the importance of the provider sharing protective strategies in the sexual health counseling session for their patients who engage in sex with female partners regardless of sexual orientation.

P04.09 Association of gender of sexual partners with women’s sexually transmitted infection risk

Background Previous data suggest that women who have sex with women and men (WSWM) have the highest STI risk compared to other female sexual behaviour groups. We compared risk behaviours and STI rates among women who have sex with women (WSW), WSWM, women with a single male partner (WSM), and women with multiple male partners. We hypothesised a continuum of STI risk with WSW having the lowest risk, followed by WSM with one partner, WSM with multiple partners, and WSWM. Methods A secondary analysis of data from two studies of African American women evaluated at a Birmingham, Alabama STD clinic was performed. One study included exclusive WSW (n = 78) and WSWM (n = 85) during the preceding year while the other evaluated WSM (n = 91 with one male partner and n = 78 with multiple male partners) during this timeframe. All participants completed a questionnaire and were tested for STIs. Results Groups did not differ by education, employment status, or recent alcohol/drug use. WSWM and WSM with multiple partners were more likely to report prior incarceration, transactional sex, and new/casual partner (s) within the past month. Rates of chlamydia and gonorrhoea were significantly different across groups with WSM more likely to have chlamydia and WSWM and WSM more likely to have gonorrhoea. In contrast, WSW and WSWM were more likely to have trichomoniasis than WSM. With the exception of WSW (25%), HSV-2 seroprevalence was high (>50%) among all groups. WSWM and WSM with multiple partners were more likely to report condom use at their last sexual encounter than WSM with single male partners and WSW. Conclusion Among women attending an STD clinic, STIs were common in all groups however prevalence appears to vary in association with partner gender and number. Even in STD clinics, partner gender and number are important factors to consider in sexual health counselling. Disclosure of interest statement Funding for original research was received from a Development Award from the American Sexually Transmitted Disease Association. No pharmaceutical grants were received in the development of this study.

Sexual and Reproductive Health Indicators and Intimate Partner Violence Victimization Among Female Family Planning Clinic Patients Who Have Sex with Women and Men.

Sexual minority women are more likely than heterosexual women to have ever experienced intimate partner violence (IPV). Although IPV is associated with sexual risk and poor reproductive health outcomes among US women overall, little is known about whether IPV is related to sexual and reproductive health indicators among sexual minority women in particular. Baseline data from a prospective intervention trial were collected from women ages 16-29 years at 24 family planning clinics in western PA (n=3,455). Multivariable logistic regression for clustered survey data was used to compare women who have sex with men only (WSM) and women who have sex with women and men (WSWM) on (1) IPV prevalence and (2) sexual and reproductive health behaviors, outcomes, and services use, controlling for IPV. Finally, we tested the interaction of sexual minority status and IPV. WSWM were significantly more likely than WSM to report a lifetime history of IPV (adjusted odds ratio (AOR): 3.00; 95% confidence interval (CI): 2.30, 3.09). Controlling for IPV, WSWM reported higher levels of sexual risk behaviors (e.g., unprotected vaginal and anal sex), male-perpetrated reproductive coercion, unwanted pregnancy, and sexually transmitted infection (STI) and pregnancy testing but less contraceptive care seeking. The association between IPV and lifetime STI diagnosis was greater among WSWM than among WSM. IPV was pervasive and associated with sexual risk and reproductive health indicators among WSWM in this clinic-based setting. Healthcare providers' sexual risk assessment and provision of sexual and reproductive health services should be informed by an understanding of women's sexual histories, including sex of sexual partners and IPV history, in order to help ensure that all women receive the clinical care they need.

A mixed methods approach to assess the likelihood of testing for STI using self-collected samples among behaviourally bisexual women

ObjectivesBehaviourally bisexual women (women who have sex with women and men (WSWM)) are more likely to report a history of sexually transmitted infections (STI) than women who have sex exclusively...

Sexual behaviours, sex toy and sexual safety methods reported by women who have sex with women and men

Background Relative to women who engage in sex with exclusively men or women, women who have sex with women and men (WSWM) are more likely to report a history of sexually transmissible infections. Knowledge of the diversity and specificity of the sexual behaviours in which they engage may provide insight into the behavioural modes of infection. The present study sought to document a range of behaviours including concurrent multi-person sexual activity (e.g. orgy, threesome), anal sexual activity and sex toy use. Barrier use methods during specific behaviours were also assessed. Eighty women who reported recent genital contact with at least one man and one woman were recruited via targeted Internet, venue-based and snowball sampling methods. Consenting participants were directed to an online survey. During an in-person timeline follow-back interview (the SEQUENCE(©) calendar method), a subset of participants (n=53) provided detailed sexual behaviour data for each sexual partner over the previous 12 months. Almost three-quarters of the sample reported at least one concurrent multi-person sexual activity. Nearly two-thirds of participants reported engaging in sexual behaviour that involved their own (66.7%) or their partner's (49.4%) anus in the past year. Barrier use for sexual behaviours other than penile-vaginal intercourse was uncommon. Behaviours and safety strategies were similar with men and women regardless of partner gender. The sexual repertoires reported by participants in this study were diverse. Understanding the range of diverse sexual behaviours of the participants may enable the construction of tailored recommendations for sexual health maintenance among WSWM.

Sexual partnership characteristics of African American women who have sex with women; impact on sexually transmitted infection risk.

African American women who have sex with women (WSW) are emerging as a population at risk for sexually transmitted infections (STIs). The objectives of this study were to explore partnership characteristics for a cohort of African American WSW and evaluate those characteristics as potential risk factors for STIs. In addition, we aimed to determine STI diagnoses and identify predictors of STI infection. Women who have sex with women presenting to a sexually transmitted disease clinic in Birmingham, AL, completed a questionnaire and were tested for bacterial vaginosis, trichomoniasis, chlamydia, gonorrhea, Mycoplasma genitalium, syphilis, HIV, and herpes simplex virus type 2. A total of 163 women were enrolled: 78 WSW and 85 women who have sex with women and men (WSWM) (based on report of past year sexual behavior). Both WSW and WSWM reported similar numbers of female partners over the lifetime, past year, and past month; however, WSWM reported significantly more lifetime male partners, thus having a higher overall number of sexual partners. Women who have sex with women and men were more likely to report new or casual partner(s), group sex, history of STIs, and sex with partner(s) known to have STIs. Overall, WSWM were more likely to have a current diagnosis of bacterial vaginosis, a current diagnosis of a curable STI, or a diagnosis of a noncurable STI (85% vs. 56%, P < 0.01). African American WSW are not a homogeneous group, and their sexual health may be directly or indirectly influenced by male partners. A better understanding of the distinctions and differences between African American WSW and WSWM will enable health care providers to improve the quality of care provided.

Lower sexually transmissible infection prevalence among lifetime exclusive women who have sex with women compared with women who have sex with women and men.

Background Sexually transmissible infection (STI) history, prevalence and seroprevalence among lifetime exclusive women who have sex with women (WSW) and an age-matched group of women who have sex with women and men (WSWM) was evaluated. Participants completed a study questionnaire and had genital specimens and sera collected for STI testing. Twenty-one lifetime exclusive WSW and 42 WSWM were included. WSWM were more likely to report a history of prior STIs and be seropositive for chlamydia and HSV-2. Prevalent STIs were less common among WSW. While lifetime exclusive WSW are at risk of contracting STIs, WSWM are disproportionally affected. Healthcare providers should consider routine STI screening among WSW.

Characterization of the Vaginal Microbiota among Sexual Risk Behavior Groups of Women with Bacterial Vaginosis

BackgroundThe pathogenesis of bacterial vaginosis (BV) remains elusive. BV may be more common among women who have sex with women (WSW). The objective of this study was to use 454 pyrosequencing to investigate the vaginal microbiome of WSW, women who have sex with women and men (WSWM), and women who have sex with men (WSM) with BV to determine if there are differences in organism composition between groups that may inform new hypotheses regarding the pathogenesis of BV.MethodsVaginal swab specimens from eligible women with BV at the Mississippi State Department of Health STD Clinic were used. After DNA extraction, 454 pyrosequencing of PCR-amplified 16S rRNA gene sequences was performed. Sequence data was classified using the Ribosomal Database Program classifer. Complete linkage clustering analysis was performed to compare bacterial community composition among samples. Differences in operational taxonomic units with an abundance of ≥2% between risk behavior groups were determined. Alpha and beta diversity were measured using Shannon’s Index implemented in QIIME and Unifrac analysis, respectively.Results33 WSW, 35 WSWM, and 44 WSM were included. The vaginal bacterial communities of all women clustered into four taxonomic groups with the dominant taxonomic group in each being Lactobacillus, Lachnospiraceae, Prevotella, and Sneathia. Regarding differences in organism composition between risk behavior groups, the abundance of Atopobium (relative ratio (RR)=0.24; 95%CI 0.11-0.54) and Parvimonas (RR=0.33; 95%CI 0.11-0.93) were significantly lower in WSW than WSM, the abundance of Prevotella was significantly higher in WSW than WSWM (RR=1.77; 95%CI 1.10-2.86), and the abundance of Atopobium (RR=0.41; 95%CI 0.18-0.88) was significantly lower in WSWM than WSM. Overall, WSM had the highest diversity of bacterial taxa.ConclusionThe microbiology of BV among women in different risk behavior groups is heterogeneous. WSM in this study had the highest diversity of bacterial taxa. Additional studies are needed to better understand these differences.

YI.5 Sexual Risk Factors Amongst Women Who Have Sex with Men and Women: The Women in Indiana Sexual Health and Experience Study (WISHES)

BackgroundPrevious research suggests that women who have sex with women and men (WSWM) may be at a higher risk for STI than women with exclusively male (WSM) or female (WSW)...

Sexual Behaviors, Perception of Sexually Transmitted Infection Risk, and Practice of Safe Sex Among Southern African American Women Who Have Sex With Women

Women who have sex with women (WSW) and women who have sex with women and men (WSWM) are frequently perceived to be at low risk for sexually transmitted infections (STIs), although data show that their STI rates are similar to heterosexual women. Little research has examined sexual behaviors, perceptions of STI risk, and practice of safe sex among African American WSW/WSWM living in the Southern United States, a population of women likely to be at high risk for STIs. Focus group discussions were conducted with African American WSW/WSWM living in Birmingham, Alabama, to explore their sexual behaviors with women, perceptions of STI risk from female (and male) sexual partners, and practice of safe sex. Digital audio-recordings were transcribed and analyzed using HyperRESEARCH software. Seven focus groups were conducted between August 2011 and March 2012, with 29 total participants. Women reported a broad range of sexual behaviors with female partners. They were more aware of their risk for STI acquisition from male partners than from female partners and felt that their best options for safe sex in their relationships with women were practicing good hygiene and requiring proof of STI testing results. African American WSW/WSWM in this study were aware of their STI risk, more so with regard to men, and desired accurate information on safer sex options in their sexual relationships with women. Health care providers can assist these women by helping them apply their existing knowledge of heterosexual STI transmission to their female sexual partnerships.