Muzny Christina A, Harbison Hanne S, Austin Erika L, Schwebke Jane R, Van Der Pol Barbara, Hook Edward W
From the Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham.
South Med J. 2017 Mar;110(3):161-167. doi: 10.14423/SMJ.0000000000000621.
Increased sexual partner numbers may contribute to sexually transmitted infection (STI) risk for some but not all women. This study compared women reporting having four or more partners during the preceding year (multiple partnership group) with those reporting having one partner (single partnership group) with regard to sexually risky behaviors and other modifiable predictors of STI risk. We also compared the prevalence of bacterial vaginosis, trichomoniasis, chlamydia, gonorrhea, syphilis, herpes simplex virus type 2, and human immunodeficiency virus among groups.
Eligible female patients 16 years and older presenting to an urban STI clinic completed a questionnaire followed by a pelvic examination with testing for bacterial vaginosis, trichomoniasis, chlamydia, and gonorrhea. Serum was collected for human immunodeficiency virus, syphilis, and herpes simplex virus type 2 serological testing.
Between May 2011 and October 2013, 213 participants were enrolled in the study: 107 in the multiple partnership group and 106 in the single partnership group. Women with multiple partners were more likely to be younger, prefer to have sex with men and women, report drug use, engage in sex for money/drugs, have sex with homosexual/bisexual men, have sex with a partner who has been incarcerated, have sex while drinking alcohol, and have a new partner as the most recent partner. Women in the single partnership group were more likely to report a regular partner and no condom use at their last sexual encounter. STI prevalence rates were high in both groups and not significantly different except for which was more common in women with multiple sex partners (18% vs 6%, = 0.01). In logistic regression analysis adjusted for age, education, partner number group, and condom use at last sexual encounter, only age 25 years and younger was associated with chlamydia (odds ratio 7.82, confidence interval 2.23-27.46).
The lack of condom use with regular sex partners in the single partnership group may have mitigated the risks associated with participation in sexually risky behaviors among the multiple partnership group, resulting in high STI rates among both groups. Women should be counseled regarding the risk of STI transmission from their regular partner or partners in addition to a casual partner or partners.
性伴侣数量增加可能会使部分女性而非所有女性面临性传播感染（STI）的风险。本研究比较了在前一年报告有四个或更多性伴侣的女性（多性伴组）和报告只有一个性伴侣的女性（单性伴组）在性风险行为以及其他可改变的STI风险预测因素方面的情况。我们还比较了两组中细菌性阴道病、滴虫病、衣原体感染、淋病、梅毒、2型单纯疱疹病毒和人类免疫缺陷病毒的患病率。
16岁及以上到城市性传播感染诊所就诊的符合条件的女性患者完成一份问卷，随后进行盆腔检查，检测细菌性阴道病、滴虫病、衣原体感染和淋病。采集血清进行人类免疫缺陷病毒、梅毒和2型单纯疱疹病毒血清学检测。
在2011年5月至2013年10月期间，213名参与者纳入研究：多性伴组107人，单性伴组106人。有多个性伴侣的女性更可能年龄较小，喜欢与男性和女性发生性行为，报告有吸毒行为，为钱/毒品而发生性行为，与同性恋/双性恋男性发生性行为，与有过监禁经历的伴侣发生性行为，在饮酒时发生性行为，且最近的性伴侣是新伴侣。单性伴组的女性更可能报告有固定伴侣且上次性行为时未使用避孕套。两组中性传播感染的患病率都很高，除了[此处原文缺失具体内容]在有多个性伴侣的女性中更常见（18%对6%，P = 0.01）外，两组之间无显著差异。在对年龄、教育程度、性伴侣数量组和上次性行为时是否使用避孕套进行校正的逻辑回归分析中，只有25岁及以下的年龄与衣原体感染相关（比值比7.82，置信区间2.23 - 27.46）。
单性伴组中与固定性伴侣发生性行为时不使用避孕套的情况可能减轻了多性伴组中参与性风险行为所带来的风险，导致两组的性传播感染率都很高。除了临时伴侣外，还应就性传播感染从固定伴侣传播的风险对女性进行咨询。
