Institute of Behavioral Science, Population Program, University of Colorado, Campus Box 484, Boulder, CO, 80309-0484, USA.
Arch Sex Behav. 2013 Feb;42(2):225-36. doi: 10.1007/s10508-012-9902-1. Epub 2012 Feb 16.
The terms MSM (men who have sex with men) and WSW (women who have sex with women) have been used with increasing frequency in the public health literature to examine sexual orientation disparities in sexual health. These categories, however, do not allow researchers to examine potential differences in sexually transmitted infection (STI) risk by sexual orientation identity. Using data from the National Longitudinal Survey of Adolescent Health, this study investigated the relationship between self-reported STIs and both sexual orientation identity and sexual behaviors. Additionally, this study examined the mediating role of victimization and STI risk behaviors on the relationship between sexual orientation and self-reported STIs. STI risk was found to be elevated among heterosexual-WSW and bisexual women, whether they reported same-sex partners or not, whereas gay-identified WSW were less likely to report an STI compared to heterosexual women with opposite sex relationships only. Among males, heterosexual-identified MSM did not have a greater likelihood of reporting an STI diagnosis; rather, STI risk was concentrated among gay and bisexual identified men who reported both male and female sexual partners. STI risk behaviors mediated the STI disparities among both males and females, and victimization partially mediated STI disparities among female participants. These results suggest that relying solely on behavior-based categories, such as MSM and WSW, may mischaracterize STI disparities by sexual orientation.
术语 MSM（男男性行为者）和 WSW（女女性行为者）在公共卫生文献中被越来越频繁地使用，以研究性取向对性健康的差异。然而，这些类别并不能让研究人员通过性取向认同来研究性传播感染（STI）风险的潜在差异。本研究利用全国青少年健康纵向调查的数据，调查了自我报告的性传播感染与性取向认同和性行为之间的关系。此外，本研究还检验了受害和性传播感染风险行为在性取向与自我报告性传播感染之间的关系中的中介作用。研究发现，无论是否报告有同性伴侣，异性恋-WSW 和双性恋女性的性传播感染风险都较高，而同性恋认同的 WSW 与仅与异性恋女性相比，报告性传播感染的可能性较小。在男性中，异性恋认同的 MSM 报告性传播感染诊断的可能性并没有增加；相反，性传播感染风险集中在报告男性和女性性伴侣的同性恋和双性恋男性中。性传播感染风险行为在男性和女性中都中介了性传播感染的差异，而受害在女性参与者中部分中介了性传播感染的差异。这些结果表明，仅依赖于基于行为的类别，如 MSM 和 WSW，可能会错误描述性取向的性传播感染差异。
