Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, VIC, 3053, Australia.
Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Arch Sex Behav. 2022 Jul;51(5):2651-2665. doi: 10.1007/s10508-022-02311-w. Epub 2022 Jul 1.
Despite rises in sexually transmitted infection (STI) notifications among Australian women in the last decade, limited STI surveillance data exist specifically for women who have sex with women. This study aimed to compare differences in sexual practices and positivity for STIs and other genital infections among women who have sex with men only (WSMO), women who have sex with women only (WSWO), and women who have sex with men and women (WSMW), and whether these changed over time. In this retrospective repeated cross-sectional study, women attending the Melbourne Sexual Health Centre for the first time between 2011 and 2019 were categorized as "WSMW," "WSWO," or "WSMO" according to self-reported sexual practices in the previous 12 months. Demographic information, sexual practices, and positivity for STIs and other genital infections were compared between the three groups and over time. A total of 36,147 women (2618 WSMW, 534 WSWO, and 32,995 WSMO) were included. WSMW reported more sexual partners (median = 6; IQR = 4-10) than WSMO (median = 3; IQR = 2-5) and WSWO (median = 2; IQR = 1-4) (p < .001). A higher proportion of WSMW always used condoms with casual male partners compared to WSMO (20.4% vs 15.9%; p < .001). The proportion of women who always used condoms with casual male partners decreased over time in WSMO, (19.9% in 2011 to 15.2% in 2019, p < .001) but not in WSMW. Bacterial vaginosis was more common in WSWO (14.8%) than in WSMW (11.8%) and WSMO (7.7%) (p < .001). Chlamydia was more common in WSMO (9.3%) than in WSMW (6.6%) and WSWO (1.2%) (p < .001). Syphilis was more common in WSMO (1.0%) than in WSMW (0.3%) and WSWO (0.0%) (p = .004). Over time, chlamydia positivity in WSWO increased (from 0.0% to 2.7%, p = .014), and syphilis positivity in WSMW increased (from 0.0% to 0.7%, p = .028); however, positivity of these STIs did not change in other groups. Sexual practices and positivity for STIs and other genital infections differed according to the sex of women's partners in the previous 12 months. Knowledge of these differences is important to account for future changes in STI trends that may occur in these subpopulations.
尽管在过去十年中，澳大利亚女性的性传播感染（STI）通知有所增加，但专门针对与女性发生性关系的女性的 STI 监测数据有限。本研究旨在比较仅与男性发生性关系的女性（WSMO）、仅与女性发生性关系的女性（WSWO）和与男性和女性发生性关系的女性（WSMW）之间在性行为和 STI 及其他生殖器感染阳性率方面的差异，以及这些差异是否随时间而变化。在这项回顾性重复横断面研究中，根据过去 12 个月的性行为自我报告，2011 年至 2019 年期间首次在墨尔本性健康中心就诊的女性被归类为“WSMW”、“WSWO”或“WSMO”。比较了三组之间的人口统计学信息、性行为以及 STI 和其他生殖器感染的阳性率，并随时间进行了比较。共纳入 36147 名女性（2618 名 WSMW、534 名 WSWO 和 32995 名 WSMO）。WSMW 报告的性伴侣数量多于 WSMO（中位数=6；IQR=4-10）和 WSWO（中位数=2；IQR=1-4）（p<0.001）。与 WSMO（20.4%）相比，更多的 WSMW 与偶然的男性性伴侣始终使用避孕套（20.4% vs 15.9%；p<0.001）。WSMO 中始终与偶然的男性性伴侣使用避孕套的女性比例随着时间的推移而下降（2011 年的 19.9%降至 2019 年的 15.2%，p<0.001），而 WSMW 中则没有。细菌性阴道病在 WSWO 中更为常见（14.8%），而在 WSMW（11.8%）和 WSMO（7.7%）中则较少见（p<0.001）。衣原体在 WSMO 中更为常见（9.3%），而在 WSMW（6.6%）和 WSWO（1.2%）中则较少见（p<0.001）。梅毒在 WSMO 中更为常见（1.0%），而在 WSMW（0.3%）和 WSWO（0.0%）中则较少见（p=0.004）。随着时间的推移，WSWO 中的衣原体阳性率增加（从 0.0%到 2.7%，p=0.014），WSMW 中的梅毒阳性率增加（从 0.0%到 0.7%，p=0.028）；然而，其他组中的这些 STI 阳性率没有变化。根据女性在过去 12 个月中与伴侣的性别，性行为和 STI 及其他生殖器感染的阳性率存在差异。了解这些差异对于解释这些亚人群中可能发生的 STI 趋势的未来变化很重要。
