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HIV Risk Factors and Associated Health Outcomes Among Sexual Minority Women in the United States - Sexual Violence, Drug Injecting, Risky Sex With Men Tied to STI Risk in US Lesbians
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Sexual Violence, Drug Injecting, Risky Sex With Men Tied to STI Risk in US Lesbians
9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris
Mark Mascolini
Sexual transmission of HIV remains rare between US women who have sex with women (WSW), but these women may run a higher risk of sexually transmitted infections (STIs) including HIV because of sexual violence, injecting drugs, and condomless sex with men [1].
A team from the Foundation for AIDS Research (amfAR) analyzed a population-based sample of sexual minority women in the United States to identify predictors of STI risk. They focused on women between 15 and 44 who participated in the 2013-2015 National Survey of Family Growth (weighted n = 61,021,314). The researchers used multivariate logistic regression to identify associations with sexual health risk factors in two sets of women: (1) WSW, and (2) women identifying as lesbian, bisexual, or gay (LBG).
The analysis included 1063 women with same-sex behavior and 4601 without same-sex behavior (the control group). Age averaged 29.1 in the same-sex group and 29.7 in the control group, a nonsignificant difference (P = 0.14). Three variables differed significantly between the two groups: The same-sex group had a higher average number of lifetime male sex partners (12.8 versus 5.7, P < 0.001), a lower proportion who married a man (26.5% versus 40.5%, P < 0.001), and a higher proportion of whites (66.7% versus 57.8%, P < 0.001).
The researchers determined that 17.6% of US women report a same-sex sexual experience, putting them in the WSW group; 19.5% report some same-sex attraction; and 8.5% identify as LBG. Adjusted analysis determined that WSW (compared with non-WSW) had increased odds of a half-dozen variables that may boost chances of STIs, at the following adjusted odds ratios (aOR) (and 95% confidence intervals) (all P < 0.05):
-- Forced sex with a man: aOR 2.60 (2.03 to 3.32)
-- Involuntary first sex: aOR 1.67 (1.15 to 2.42)
-- STI test in past 12 months: aOR 1.51 (1.18 to 1.94)
-- Induced abortion: aOR 2.12 (1.50 to 2.98)
-- Use of emergency contraception: aOR 1.50 (1.17 to 1.92)
-- Ever injected drugs not prescribed: aOR 6.33 (3.43 to 11.70)
Results were largely similar when the researchers compared LBG women with straight women, except that the LGB group did not have higher adjusted odds of an STI test in the past 12 months or emergency contraception.
The amfAR team noted that several independent risk variables are proxies for condomless sex with men, including forced sex with a man, involuntary forced sex, abortion, and emergency contraception. The researchers cautioned healthcare providers that "sexual identity does not always predict behavior, or risk, and that women who identify as LBG may still be at risk for HIV." They suggested that WSW "would benefit from trauma-informed medical care" and interventions addressing HIV risk from injecting drugs and condom-free sex with men.
Reference
1. Sherwood J, Sharp A, Honermann B, Blumenthal S, Millett G. HIV risk factors and associated health outcomes among sexual minority women in the United States. 9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris. Abstract TUPEC0771.
HIV Risk Factors and Associated Health Outcomes Among Sexual Minority Women in the United States
Authors: J. Sherwood, A. Sharp, B. Honermann, S. Blumenthal, G. Millett
Institution: amfAR, The Foundation for AIDS Research, Public Policy Office, Washington DC, United States
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