性传播感染和与女性发生性关系的非裔美国女性的风险行为：与男性发生性关系有区别吗？
Sexually transmitted infections and risk behaviors among African American women who have sex with women: does sex with men make a difference?
机构信息
Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
出版信息
Sex Transm Dis. 2011 Dec;38(12):1118-25. doi: 10.1097/OLQ.0b013e31822e6179.
OBJECTIVE
We sought to determine the prevalence of infection with Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, syphilis, and HIV among African American women who have sex with women (AAWSW), and compare sociodemographics, sexual risk behavior characteristics, and STI diagnoses among women reporting sex exclusively with women (exclusive AAWSW) to women reporting sex with both women and men (AAWSWM) during the past 12 months.
METHODS
Eligible women presenting to the Mississippi State Department of Health STD Clinic between February 2009 and October 2010 were invited to participate. A survey on sociodemographics, sexual history, and sexual risk behavior characteristics was completed. Women were tested for the presence of C. trachomatis, N. gonorrhoeae, T. vaginalis, M. genitalium, syphilis, and HIV.
RESULTS
A total of 196 African American women were enrolled; 56.6% of all women reported engaging in sexual activity exclusively with women (AAWSW) during the past 12 months and 40.8% reported engaging in sexual activity with both men and women (AAWSWM). As compared with exclusive AAWSW, AAWSWM were significantly more likely to report prior infection with C. trachomatis (35.0% vs. 13.5%, P < 0.001), prior infection with N. gonorrhoeae (28.75% vs. 2.7%, P < 0.001), and transactional sex (18.8% vs. 2.7%, P = 0.001). Additionally, 13.8% of AAWSWM reported having sex with a homosexual or bisexual man during the past 12 months. Trichomoniasis was diagnosed in 18.3% of all women, C. trachomatis in 11.0%, M. genitalium in 7.6%, and N. gonorrhoeae in 3.7%. There were no cases of syphilis or HIV. AAWSWM were significantly more likely to be diagnosed with trichomoniasis (25.0% vs. 13.5%, P = 0.04), C. trachomatis (22.5% vs. 2.7%, P < 0.001), N. gonorrhoeae (7.5% vs. 0.9%, P = 0.01), or any STI (47.5% vs. 18.3%, P < 0.001) than exclusive AAWSW.
CONCLUSIONS
AAWSW in this study were at high risk for STI. AAWSWM, as a subgroup, may demonstrate heightened sexual risk-taking behaviors and higher STI rates compared with exclusive AAWSW. Sexual health services provided to AAWSW should take into account partner gender heterogeneity when counseling and screening for STI.
目的
我们旨在确定性活跃的非裔美国女性（AAWSW）中沙眼衣原体（Chlamydia trachomatis）、淋病奈瑟菌（Neisseria gonorrhoeae）、阴道毛滴虫（Trichomonas vaginalis）、生殖支原体（Mycoplasma genitalium）、梅毒和 HIV 的感染率，并比较过去 12 个月中报告仅与女性发生性行为（仅 AAWSW）和报告与女性和男性均发生性行为（AAWSWM）的女性在社会人口统计学、性行为特征和性传播感染（STI）诊断方面的差异。
方法
2009 年 2 月至 2010 年 10 月期间，符合条件的非裔美国女性在密西西比州卫生部 STD 诊所就诊时被邀请参与研究。完成了一份关于社会人口统计学、性史和性行为特征的调查问卷。对女性进行沙眼衣原体、淋病奈瑟菌、阴道毛滴虫、生殖支原体、梅毒和 HIV 的检测。
结果
共有 196 名非裔美国女性入组；所有女性中，56.6%报告在过去 12 个月中仅与女性发生性行为（AAWSW），40.8%报告与男性和女性均发生性行为（AAWSWM）。与仅 AAWSW 相比，AAWSWM 更有可能报告既往感染沙眼衣原体（35.0% vs. 13.5%，P<0.001）、既往感染淋病奈瑟菌（28.75% vs. 2.7%，P<0.001）和商业性性行为（18.8% vs. 2.7%，P=0.001）。此外，13.8%的 AAWSWM 报告在过去 12 个月中与男同性恋或双性恋男性发生过性行为。所有女性中，18.3%诊断为滴虫病，11.0%诊断为沙眼衣原体感染，7.6%诊断为生殖支原体感染，3.7%诊断为淋病奈瑟菌感染。未发现梅毒或 HIV 病例。AAWSWM 更有可能被诊断为滴虫病（25.0% vs. 13.5%，P=0.04）、沙眼衣原体感染（22.5% vs. 2.7%，P<0.001）、淋病奈瑟菌感染（7.5% vs. 0.9%，P=0.01）或任何 STI（47.5% vs. 18.3%，P<0.001），而与仅 AAWSW 相比。
结论
本研究中的 AAWSW 感染性传播感染的风险较高。AAWSWM 作为一个亚组，与仅 AAWSW 相比，其性行为风险更高，性传播感染率更高。向 AAWSW 提供的性健康服务在进行 STI 咨询和筛查时应考虑到伴侣的性别异质性。
Zotero 插件