Is the Risk for Sexually Transmissible Infections (STI) Lower among Women with Exclusively Female Sexual Partners Compared with Women with Male Partners? A Retrospective Study Based on Attendees at a Norwegian STI Clinic from 2004 to 2014

Background:

The prevalence of and the risk for sexually transmissible infections (STIs) for women engaging in same-sex sexual behaviour was investigated among women attending an STI clinic.

Methods:

Data from electronic medical records were reviewed and logistic regression used to estimate the odds ratio (OR) of STIs. Women reporting life-time exclusively female partners (WSW) and women reporting female and male partners (WSWM) were compared with women reporting exclusively male partners (WSM). Outcomes included: Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoea, HIV and syphilis.

Results:

The study population comprised 103 564 women (WSW 641, WSWM 12 010 and WSM 90 913). Overall prevalence of STIs was 8%. Crude OR of STIs for WSW: 0.56 (95% CI 0.39-0.81), for WSWM: 0.99 (95% CI 0.92-1.06) compared with WSM. Multivariate analysis revealed an interaction effect between same-sex sexual behaviour and smoking. Among non-smokers; WSW adjusted OR was 0.41 (95% CI 0.21-0.80), WSWM adjusted OR was 0.91 (95% CI 0.81-1.02) compared with WSM. Among smokers; WSW adjusted OR was 1.03 (95% CI 0.63-1.67) for WSWM adjusted OR was 1.00 (CI 95% 0.93-1.13), compared with WSM.

Conclusion:

This study, including the largest cohort of women reporting life-time exclusively female partners in an STI study, shows that WSW generally are at lower risk for acquiring STIs than WSM. Smoking WSW, however, had the same risk for acquiring bacterial STIs as WSM and WSWM. Our study suggests that all WSW should receive the same encouragement to test for STIs as WSM.

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By:  Sol-Britt Molin ^A B F, Birgitte Freiesleben De Blasio ^C D and Anne Olaug Olsen ^A B E 

^A Department of Rheumatology, Dermatology and Infectious Diseases, The Olafia Clinic p.o.b.4763, Oslo University Hospital, 0506 Oslo, Norway. 
^B Norwegian National Advisory Unit on Sexually Transmitted Infections, The Olafia Clinic p.o.b.4763, vv0506 Oslo, Norway. 
^C Oslo Centre for Biostatics and Epidemiology, Department of Biostatics, p.o.b1122 Blindern, Institute of Basic Medical Sciences, University of Oslo, 0317 Oslo, Norway. 
^D Department of Infectious Disease Epidemiology, Division of Infectious Disease Control, Norwegian Institute of Public Health, p.o.b.4404 Nydalen, 0403 Oslo, Norway. 
^E Institute of Clinical Medicine, University of Oslo, p.o.b.1171 Blindern, 0318 Oslo, Norway. 
^F Corresponding author. Email: solmol@ous-hf.no 

Sex Health. 2016 Apr 7. doi: 10.1071/SH15193. 

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Women’s Views and Experiences of the Triggers for Onset of Bacterial Vaginosis and Exacerbating Factors Associated with Recurrence

Background

Bacterial vaginosis (BV) is the most common vaginal infection affecting women of childbearing age. While the aetiology and transmissibility of BV remain unclear, there is strong evidence to suggest an association between BV and sexual activity. This study explored women’s views and experiences of the triggers for BV onset and factors associated with recurrence.

Methods

A descriptive, social constructionist approach was chosen as the framework for the study. Thirty five women of varying sexual orientation who had experienced recurrent BV in the past five years took part in semi-structured interviews.

Results

The majority of women predominantly reported sexual contact triggered the onset of BV and sexual and non-sexual factors precipitated recurrence. Recurrence was most commonly referred to in terms of a ‘flare-up’ of symptoms. The majority of women did not think BV was a sexually transmitted infection however many reported being informed this by their clinician. Single women who attributed BV onset to sex with casual partners were most likely to display self-blame tendencies and to consider changing their future sexual behaviour. Women who have sex with women (WSW) were more inclined to believe their partner was responsible for the transmission of or reinfection with BV and seek partner treatment or change their sexual practices.

Conclusion

Findings from this study strongly suggest women believe that BV onset is associated with sexual activity, concurring with epidemiological data which increasingly suggest BV may be sexually transmitted. Exacerbating factors associated with recurrence were largely heterogeneous and may reflect the fact it is difficult to determine whether recurrence is due to persistent BV or a new infection in women. There was however evidence to suggest possible transmission and reinfection among WSW, reinforcing the need for new approaches to treatment and management strategies including male and female partner treatment trials.

Below:  Triggers for BV onset

Full article at:  http://goo.gl/FqXVLz

By:  

Jade Bilardi, Sandra Walker, Clare Bellhouse, Christopher Fairley, Marcus Chen, Catriona Bradshaw
Central Clinical School, Monash University, Melbourne, Victoria, Australia

Jade Bilardi, Meredith Temple-Smith, Ruth McNair

Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia

Jade Bilardi, Sandra Walker, Clare Bellhouse, Christopher Fairley, Marcus Chen, Catriona Bradshaw

Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia

Julie Mooney-Somers

Centre for Values, Ethics and the Law in Medicine, The University of Sydney, Sydney, New South Wales, Australia

Catriona Bradshaw

Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia

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Women Who Have Sex with Women in Kenya and Their Sexual and Reproductive Health

Purpose: To describe sexual and reproductive health characteristics of women who have sex with women (WSW) in Kenya's three most populous cities: Kisumu, Mombasa, and Nairobi. Although the last decade has shown an upsurge of health-related research studies in African sexual minority populations, these studies have generally concentrated on the health status of men who have sex with men to the exclusion of WSW. This study presents the first findings on Kenyan WSW's sexual and reproductive health.

Methods: A community-based, cross-sectional survey was conducted among 280 women who were at least 18 years old, had at least one female sexual partner in the past three years, and were Kenyan residents.

Results: A significant proportion of participants reported that they had at least one male sexual partner in the past three years (38.9%), ever had an abortion (13.2%), been infected with at least one sexually transmitted infection (STI) in the past three years (33.9%), and been tested for HIV at least once (88.9%). Of the women who reported having been tested for HIV, 9.4% (7.5% of the total sample) received a positive test result. Some women noted that they were open with their doctors about their sexual orientation, and that their doctors had not reacted negatively to this information.

Conclusion: WSW in Kenya are at risk for negative sexual and reproductive health outcomes, including HIV, STIs, unplanned pregnancy, and unsafe abortion, positioning these women as a critical population for public health efforts. Some WSW actively exercise their agency in making important health decisions. Therefore, this study indicates a need to incorporate WSW's health concerns within Kenyan national health policy programming.

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By:   Sidra S. Zaidi, MA,^1,2 Akinyi M. Ocholla, MA,³ Rena A. Otieno,⁴ and Theo G.M. Sandfort, PhD^1,2

¹Division of Gender, Sexuality and Health, Department of Psychiatry, Columbia University, New York, New York.

²New York State Psychiatric Institute, New York, New York.

³Minority Women in Action, Nairobi, Kenya.

⁴Women Working with Women, Kisumu, Kenya.

Address correspondence to:

Theo G.M. Sandfort, PhD

Division of Gender, Sexuality and Health

Department of Psychiatry

Columbia University and New York

State Psychiatric Institute

1051 Riverside Drive, Unit 15

New York, NY 10031

E-mail: tgs2001@cumc.columbia.edu

 

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