Fethers K, Marks C, Mindel A, Estcourt C S
Sydney Sexual Health Centre, Sydney Hospital, Australia.
Sex Transm Infect. 2000 Oct;76(5):345-9. doi: 10.1136/sti.76.5.345.
To assess the prevalence of sexually transmitted infections (STIs) and blood borne viruses, risk behaviours, and demographics in women who have sex with women (WSW).
Retrospective cross sectional study using a multivariate model. Demographic, behavioural, and morbidity data were analysed from standardised medical records of patients attending a public STI and HIV service in Sydney between March 1991 and December 1998. All women with any history of sex with a woman were compared with women who denied ever having sex with another woman (controls).
1408 WSW and 1423 controls were included in the study. Bacterial vaginosis (BV) was significantly more common among WSW (OR 1.7, p < 0.001). Abnormalities on cervical cytology were equally prevalent in both groups, except for the higher cytological BV detection rate in WSW (OR 5.3, p = 0.003). Genital herpes and genital warts were common in both groups, although warts were significantly less common in WSW (OR 0.7, p = 0.001). Prevalence of gonorrhoea and chlamydia were low and there were no differences between the groups. The prevalence of hepatitis C was significantly greater in WSW (OR 7.7, p < 0.001), consistent with the more frequent history of injecting drug use in this group (OR 8.0, p < 0.001). WSW were more likely to report previous sexual contact with a homo/bisexual man (OR 3.4, p < 0.001), or with an injecting drug user (OR 4.2, p < 0.001). Only 7% of the WSW reported never having had sexual contact with a male.
We demonstrated a higher prevalence of BV, hepatitis C, and HIV risk behaviours in WSW compared with controls. A similar prevalence of cervical cytology abnormalities was found in both groups. Measures are required to improve our understanding of STI/HIV transmission dynamics in WSW, to facilitate better health service provision and targeted education initiatives.
评估与女性发生性行为的女性（WSW）中性传播感染（STIs）和血源病毒的流行情况、风险行为及人口统计学特征。
采用多变量模型进行回顾性横断面研究。分析了1991年3月至1998年12月期间在悉尼一家公共性传播感染和艾滋病服务机构就诊的患者标准化病历中的人口统计学、行为学和发病率数据。将所有有与女性发生性行为史的女性与否认曾与另一名女性发生性行为的女性（对照组）进行比较。
1408名WSW和1423名对照组纳入研究。细菌性阴道病（BV）在WSW中显著更常见（比值比[OR]1.7，p<0.001）。宫颈细胞学异常在两组中同样普遍，不过WSW中细胞学BV检测率更高（OR 5.3，p = 0.003）。两组中生殖器疱疹和尖锐湿疣都很常见，尽管尖锐湿疣在WSW中显著较少见（OR 0.7，p = 0.001）。淋病和衣原体感染的患病率较低，两组之间无差异。丙型肝炎的患病率在WSW中显著更高（OR 7.7，p<0.001），这与该组更频繁的注射吸毒史一致（OR 8.0，p<0.001）。WSW更有可能报告曾与男同性恋者/双性恋男性（OR 3.4，p<0.001）或注射吸毒者（OR 4.2，p<0.001）有过性接触。只有7%的WSW报告从未与男性有过性接触。
我们证明与对照组相比，WSW中BV、丙型肝炎和艾滋病风险行为的患病率更高。两组中宫颈细胞学异常的患病率相似。需要采取措施来增进我们对WSW中性传播感染/艾滋病传播动态的理解，以促进更好的卫生服务提供和有针对性的教育举措。
