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Babcock N, Zarate J, Wang S, Watson RJ, Eaton LA, Snapp SD. How LGBTQ+ Young Adults Navigate Personal Risk in App-Based Hookups: The Safety Spectrum Theory. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2347-2359. [PMID: 38664349 DOI: 10.1007/s10508-024-02864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 06/14/2024]
Abstract
Research on hooking up is rife with examinations of risky sexual health practices among LGBTQ+ young adults; yet, little has been written about the personal safety practices for this population. This omission is notable because safety practices can enhance the notable positive outcomes related to hooking up. Drawing on one-on-one interviews with 50 LGBTQ+ young adults (20 cismen, 20 ciswomen, two transmen, and eight others) in British Columbia, California, and Connecticut, we developed the safety spectrum theory, which used a spectral measurement to assess how LGBTQ+ young adults negotiate safety practices and implement safety rules. This spectrum was then applied to a three-step sequence of application (app)-based hookup rituals: online initiation, pre-meeting preparation, and in-person meetup. Results indicated that safety strategies may be dictated by situational factors, where individuals adapt to varying circumstances to be more in control of personal safety when hooking up. We further identified that participants move across the spectrum depending upon contextual factors, such as the gender of the potential hookup partner. This work suggests that LGBTQ+ young adults are mindful of their personal safety and deserve more credit than previously attributed in queer and sexual health research. From these findings, we provide evidence-based recommendations to make dating/hookup apps and public health campaigns more effective at mitigating hookup-related risks.
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Affiliation(s)
- Nikole Babcock
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd., U-1058, Storrs, CT, 06269, USA.
| | - Jose Zarate
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Skyler Wang
- Department of Sociology, University of California, Berkeley, Berkeley, CA, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd., U-1058, Storrs, CT, 06269, USA
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd., U-1058, Storrs, CT, 06269, USA
| | - Shannon D Snapp
- Department of Psychology, California State University, Monterey Bay, Seaside, CA, USA
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Huamaní-Chavez V, Rueda-Torres L, Ormeño-Delgado L, Li J, Rosales-Rimache J. Syphilis seroprevalence and associated factors: A cross-sectional study in formal female sex workers in a province of Peru. Medicine (Baltimore) 2024; 103:e37774. [PMID: 38608070 PMCID: PMC11018198 DOI: 10.1097/md.0000000000037774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/12/2024] [Indexed: 04/14/2024] Open
Abstract
Syphilis is a sexually transmitted infection (STI) considered a public health problem that affects vulnerable and at-risk populations, such as sex workers. We designed a retrospective cross-sectional study based on the review of health evaluation records of sex workers who attended consultations to obtain comprehensive health cards at a Health Center in the Province of San Vicente de Cañete in Peru during the year 2020. We obtained sociodemographic and employment information and the RPR (rapid plasma reagin) test results to diagnose syphilis. We evaluated 220 records of sex workers with a mean age of 27.9 ± 6.9 years and the initiation of sexual relations of 16.0 ± 1.6 years, while the accumulated time they had as sex workers was 2.9 ± 2.4 years. 85.9% of those evaluated reported being heterosexual. The prevalence of syphilis was 7.3% (CI95: 4.2%-11.5%). Being a homosexual sex worker was significantly associated with syphilis (OR: 19.6; 95% CI: 4.8-80.0) compared to heterosexuals. The prevalence of syphilis presented a value similar to that reported in other Latin American and national studies, and it is evident that it is a health problem among sex workers.
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Affiliation(s)
| | | | | | - Jair Li
- Universidad Nacional Federico Villarreal, Lima, Perú
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Wang X, Ouyang Z, Liu E, Han M. Sexually transmitted infections and associated risk factors among sexual minority women in China. Sci Rep 2023; 13:21583. [PMID: 38062127 PMCID: PMC10703893 DOI: 10.1038/s41598-023-48745-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
There is a potential for transmission of sexually transmitted infections (STIs) within sexual minority women (SMW) in China. However, research specifically focused on STIs among SMW in China is severely limited. This study aims to evaluate the prevalence of STIs and identify associated risk factors among SMW in Beijing, China. This study comprised a baseline assessment followed by a follow-up evaluation. Consistent questionnaire interviews and STI tests were administered during both stages. Participants were recruited online in Beijing between 2020 and 2021 and factors associated with STIs were analyzed using logistic and Cox regression models. The baseline included 219 SMW, and 58.9% (129/219) of these individuals participated in the follow-up. During the baseline assessment, 4.1% (9/219) tested positive for chlamydia infection, while 5.0% (11/219) were HSV-2 seropositive. At the follow-up, the incidence of HSV-2 was 3.7 cases per 100 person-years. Notably, engaging in sexual activity with men and having an increased number of sexual partners were both identified as factors associated with a higher risk of STIs. The findings suggest that SMW in Beijing may face a significant risk of contracting STIs. As a preventive measure, there should be a concerted effort to promote STI testing within the SMW community.
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Affiliation(s)
- Xiaofang Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
| | - Zhaohui Ouyang
- Jinsong Community Hospital, Chaoyang District, Beijing, China
| | - Enwu Liu
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Mengjie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China
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Collar AL, Brakey HR, Fuentes JE, Frietze KM. Medical Counseling on Sexual Enrichment Aids: Women's Preferences and Medical Practitioner Expertise. Obstet Gynecol 2022; 140:489-498. [PMID: 35926212 PMCID: PMC9669100 DOI: 10.1097/aog.0000000000004892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/28/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate women's preferences and experiences regarding health counseling of safe sexual enrichment aid use and hygiene and current counseling behaviors of medical practitioners on this topic. METHODS This study used mixed methodology, leveraging quantitative data from a cross-sectional survey of 800 women and semi-structured qualitative interview data from 24 women across sexual practice groups. Additionally, we conducted a cross-sectional survey of 192 medical practitioners to understand current counseling behaviors and attitudes. RESULTS The majority of women (96.2%, 607/631) had never been counseled by a practitioner on safe sexual enrichment aid use and hygiene but would feel comfortable receiving counseling on the subject under certain circumstances. Overwhelmingly, women indicated the need for a nonjudgmental practitioner. Many cited the importance of having a female practitioner and preferred one within obstetrics and gynecology. Among medical practitioners, counseling on this topic was infrequent; 27.0% (52/192) stated that they counsel patients on safe sexual enrichment aid use and hygiene when discussing safe sex, and 21.4% (41/192) reported that this topic is included when counseling women after a sexually transmitted infection diagnosis. Only 7.4% (14/188) and 6.4% (12/188) had received training on this topic or were aware of any professional guidelines or recommendations, respectively. CONCLUSION Evidence-based guidelines should be developed that practitioners can use to counsel patients, ensuring that women are able to engage in sexual enrichment aid use safely.
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Affiliation(s)
- Amanda L. Collar
- Department of Molecular Genetics & Microbiology, School of Medicine, University of New Mexico, Albuquerque, NM
| | - Heidi Rishel Brakey
- Community Engagement & Research Core, Clinical & Translational Science Center, Health Sciences Center, University of New Mexico, Albuquerque, NM
| | - Jesus E. Fuentes
- Community Engagement & Research Core, Clinical & Translational Science Center, Health Sciences Center, University of New Mexico, Albuquerque, NM
| | - Kathryn M. Frietze
- Department of Molecular Genetics & Microbiology, School of Medicine, University of New Mexico, Albuquerque, NM
- Clinical & Translational Science Center, Health Sciences Center, University of New Mexico, Albuquerque, NM
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Engel JL, Fairley CK, Greaves KE, Vodstrcil LA, Ong JJ, Bradshaw CS, Chen MY, Phillips TR, Chow EPF. Patterns of Sexual Practices, Sexually Transmitted Infections and Other Genital Infections in Women Who Have Sex with Women Only (WSWO), Women Who Have Sex with Men Only (WSMO) and Women Who Have Sex with Men and Women (WSMW): Findings from a Sexual Health Clinic in Melbourne, Australia, 2011-2019. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2651-2665. [PMID: 35776396 PMCID: PMC9293838 DOI: 10.1007/s10508-022-02311-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 06/15/2023]
Abstract
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, ptrend < .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%, ptrend = .014), and syphilis positivity in WSMW increased (from 0.0% to 0.7%, ptrend = .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.
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Affiliation(s)
- Jaimie L Engel
- 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
| | - Christopher K Fairley
- 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
| | - Kate E Greaves
- 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
| | - Lenka A Vodstrcil
- 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
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jason J Ong
- 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
| | - Catriona S Bradshaw
- 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
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Marcus Y Chen
- 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
| | - Tiffany R Phillips
- 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.
| | - Eric P F Chow
- 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
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Haase S, Müller A, Zweigenthal V. Sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya: An online cross-sectional study. PLoS One 2022; 17:e0268298. [PMID: 35714150 PMCID: PMC9205489 DOI: 10.1371/journal.pone.0268298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 04/23/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Little research has been conducted on the sexual health needs and risk behaviors of queer womxn and trans men, making it difficult to identify specific health needs and disparities. This is especially the case in the Global South, where their needs are poorly understood. This study presents findings on demographics, sources of information, sexual (risk) behaviors, and substance use in Kenyan queer womxn and trans men. Methods An online survey among 335 Kenyan queer womxn and trans men was used to collect data on sexual health, risk behavior, health information sources, and substance use. The participants needed to have had at least one self-identified female sexual partner. Results The sample presented young, highly-educated queer womxn and trans men. A high incidence of childhood sexual trauma found was found. Risk behaviors included sexual activities with partners of multiple genders, violence, and low use of barrier methods. One in three participants had been treated for an STD in the previous year. The incidences of smoking and drinking were high, and a quarter of participants indicated having taken drugs at least once a month or more. The internet was either the first or second most important source of sexual health information for 44.1% of the participants, followed by schools (30.9%). Discussion and conclusion Our findings indicate that queer womxn and trans men are at risk of negative sexual health outcomes due to a lack of appropriate information, risk behavior, substance use, and low uptake of sexual health services. Kenya’s Penal Code still criminalizes consensual same-sex activities and may play a role in perpetuating barriers that prohibit them from making healthier choices. Developing tailored programming and policies require local, national, and global stakeholders to engage with the inclusion of queer womxn and trans men’s sexual health needs within strategic planning and healthcare delivery.
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Affiliation(s)
- Stephanie Haase
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Alex Müller
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Virginia Zweigenthal
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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7
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Kanazawa S, Larere A. Infertility and same-sex attraction in women. Int J Gynaecol Obstet 2021; 158:528-543. [PMID: 34796501 DOI: 10.1002/ijgo.14035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/17/2021] [Indexed: 11/07/2022]
Abstract
A polygyny hypothesis of female sexual fluidity proposes that women may have been evolutionarily selected to be sexually fluid, in order to have occasional sex with their cowives in polygynous marriage to reduce tension and conflict inherent in such marriage, while at the same time reproducing children with their husbands. Among others, the hypothesis predicts that women who are biologically (but not surgically) infertile would experience greater same-sex attraction. Biological infertility stems from natural, evolutionarily familiar causes such as menopause, whereas surgical infertility stems from artificial, evolutionarily novel causes such as tubal ligation or hysterectomy. Consistent with the prediction, the analyses of the National Survey of Family Growth data showed that biological infertility, but not surgical infertility, was significantly associated with same-sex self-identified labels, behavior and sexual attraction in women. Biological infertility nearly doubled the odds of women having engaged in same-sex behavior and the number of same-sex partners in the last 12 months and nearly tripled the number of same-sex partners in life. In sharp contrast, biological infertility was not associated (and surgical infertility was significantly negatively associated) with same-sex attraction in men.
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Affiliation(s)
- Satoshi Kanazawa
- Department of Management, London School of Economics and Political Science, London, UK
| | - Adrien Larere
- Department of Management, London School of Economics and Political Science, London, UK
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Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 825] [Impact Index Per Article: 275.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for
sexually transmitted infections (STIs) were updated by CDC after consultation
with professionals knowledgeable in the field of STIs who met in Atlanta,
Georgia, June 11–14, 2019. The information in this report updates the
2015 guidelines. These guidelines discuss 1) updated recommendations for
treatment of Neisseria gonorrhoeae, Chlamydia trachomatis,
and Trichomonas vaginalis; 2) addition of
metronidazole to the recommended treatment regimen for pelvic inflammatory
disease; 3) alternative treatment options for bacterial vaginosis; 4) management
of Mycoplasma genitalium; 5) human papillomavirus vaccine
recommendations and counseling messages; 6) expanded risk factors for syphilis
testing among pregnant women; 7) one-time testing for hepatitis C infection; 8)
evaluation of men who have sex with men after sexual assault; and 9) two-step
testing for serologic diagnosis of genital herpes simplex virus. Physicians and
other health care providers can use these guidelines to assist in prevention and
treatment of STIs.
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Khryanin AA, Knorring GY. Bacterial vaginosis: controversial issues. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The purpose of the review. Consideration of the most controversial issues regarding the possibility of sexual transmission of BV-associated microorganisms (bacterias) in women and men.
Basic provisions. Bacterial vaginosis (BV) is a common disease associated with an increased risk of contracting sexually transmitted infections (including human papillomavirus and human immunodeficiency virus) in women and their male sexual partners. BV is characterized by polymicrobial transformations caused by Gardnerella vaginalis, which is the main etiological microorganism of this disease. G. vaginalis has a proven ability to form microbial biofilms on the mucosal surface. As a rule, from 10 to 12 different G. vaginalis genotypes can simultaneously reside in one biofilm, which provides it with a longer lifespan and viability. It has been shown that microorganisms in the biofilm acquire properties that reduce sensitivity to standard etiotropic therapy even at high doses of antibiotics. It was found that the cause of BV is a polymicrobial gardnerella biofilm, all components of which are transferred as a whole (for example, with the help of key cells), including during sexual contact. In this regard, the article discusses the possibility of using a new term biofilm gardnerellosis, which more accurately reflects the essence of this problem. Microbial biofilms organized by G. vaginalis are found in a significant number of women with BV and their sexual partners.
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Rahman N, Ghanem KG, Gilliams E, Page KR, Tuddenham S. Factors associated with sexually transmitted infection diagnosis in women who have sex with women, women who have sex with men and women who have sex with both. Sex Transm Infect 2020; 97:423-428. [PMID: 33122425 DOI: 10.1136/sextrans-2020-054561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/27/2020] [Accepted: 09/27/2020] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Many US women report same sex behaviour, yet data on risk factors and STIs in women who have sex with women (WSW), women who have sex with both men and women (WSB) and how these compare to women who have sex with men only (WSM) remain limited. Here we compared self-identified WSW, WSB and WSM attending two STI clinics in Baltimore, Maryland. METHODS This was a retrospective analysis using a database of first clinic visits 2005-2016. WSW and WSB were compared with an age-matched random sample of WSM. Proportions were compared using the χ2 test. Acute STI (aSTI) was defined as gonorrhoea (Neisseria gonorrhoeae, GC), chlamydia (Chlamydia trachomatis, CT), trichomonas (Trichomonas vaginalis, TV) or early syphilis. Logistic regression was used to assess aSTI predictors. CT testing was not uniformly done, so a sensitivity analysis removing CT from the aSTI definition was conducted. RESULTS Visits from 1095 WSW, 1678 WSB and 2773 WSM were analysed. WSB had equal or higher test positivity for all STIs except urogenital chlamydia, had more sexual partners, were more likely to engage in transactional sex and were more likely to report drug use and binge drinking than WSM (p≤0.01). WSW had lower test positivity for urogenital GC and CT than WSM or WSB, but comparable test positivity for TV, higher reported binge drinking and comparable reported substance use as WSM. Younger age and cocaine use predicted STI diagnosis only in WSM. CONCLUSIONS WSB in these clinics bear an equal or higher burden of most STIs, have more partners and report more substance use than WSM. WSW carry a lower, but still substantial burden of STIs, and many report substance use. Factors predicting STI diagnosis differ between WSW, WSB and WSM suggesting that tailored STI prevention and testing approaches are needed in these groups.
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Affiliation(s)
- Nazia Rahman
- Henry M Jackson Foundation for the Advancement of Military Medicine, USU Preventive Medicine and Biostatistics, Bethesda, Maryland, USA.,Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Khalil G Ghanem
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Gilliams
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Baltimore City Health Department, Division of Population Health and Disease Prevention, Sexual Health Clinics, Baltimore, Maryland, USA
| | - Kathleen R Page
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Susan Tuddenham
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Wikramanayake RM, Paschen-Wolff MM, Matebeni Z, Reddy V, Southey-Swartz I, Sandfort TGM. Southern African Lesbian and Bisexual Women Responses to Symptoms of Sexually Transmitted Infections. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1887-1902. [PMID: 31950379 PMCID: PMC7321908 DOI: 10.1007/s10508-019-01581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/11/2019] [Accepted: 10/31/2019] [Indexed: 06/10/2023]
Abstract
Sexually transmitted infection (STI) in lesbian and bisexual women is a relatively unexplored topic, particularly for women from low- and middle-income countries. Despite perceptions that women who have sex with women (WSW) are at negligible risk of contracting STI, existing research demonstrates that WSW do become infected with STI. Given the opposition between assumptions of invulnerability and the observed risks, we explored how WSW would respond to symptoms of STI (i.e., wait until symptoms passed, see a medical doctor, and inform sexual partners). We used data collected as part of a collaboration between academic researchers and community-based LGBTQ organizations in Botswana, Namibia, South Africa, and Zimbabwe. Chi-squared tests were used to test whether participants' responses to hypothetical STI symptoms varied in relation to several intrapersonal, interpersonal, and structural factors. Multivariable logistic regression (backward) was used to assess whether these variables were independently associated with women's responses. Most women would be proactive in response to potential STI symptoms and would see a medical doctor. However, most women would not inform their sexual partner of symptoms of STI. Findings demonstrate several intrapersonal, interpersonal, and structural factors that influence WSW's health agency, and show a clustering of high-risk factors among women who would not be proactive about their health. Our findings suggest the need for improved health and health care of WSW in Southern Africa.
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Affiliation(s)
- Radhika M Wikramanayake
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
| | - Margaret M Paschen-Wolff
- Department of Psychiatry, Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, USA
| | - Zethu Matebeni
- Department of Sociology, University of the Western Cape, Cape Town, South Africa
| | - Vasu Reddy
- Faculty of the Humanities, University of Pretoria, Pretoria, South Africa
| | | | - Theo G M Sandfort
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
- Department of Psychology, University of Pretoria, Pretoria, South Africa.
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12
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Rodríguez-Otero LM. [Literature review on studies of women who have sex with women]. Medwave 2020; 20:e7884. [PMID: 32343685 DOI: 10.5867/medwave.2020.03.7884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/27/2020] [Indexed: 11/27/2022] Open
Abstract
Women who have sex with other women are a group that has been mostly invisible from public health policies. This category includes the group of lesbians, bisexual women, heterosexual behaviour, and homosexual practices, who have sexual relations with transsexual and transgender (trans) women and trans men who have sex with women. In the absence of a Spanish literature review of a study that addresses women who have sex with other women, a narrative bibliographic review was done using the PubMed/MEDLINE, Scopus, Dialnet, and Taylor and Francis databases. From a universe of 679 articles and after applying the inclusion criteria, 40 documents were analysed, from 1998 to 2019. Three meta-categories were identified (sexual education, the incidence of certain sexually transmitted infections, and aspects related to sexual practices), concerning prevention and risky behaviours. Women who have sex with other women are a particularly vulnerable group when it comes to sexually transmitted infections. These may include bacterial vaginitis, human papillomavirus and acquired immunodeficiency virus. Likewise, there is a lack of specific training and information in health and education professionals, as well as in women who have sex with other women.
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Affiliation(s)
- Luis Manuel Rodríguez-Otero
- Facultad de Trabajo Social y Desarrollo Humano, Universidad Autónoma de Nuevo León, Nuevo León, México. . ORCID: 0000-0002-1748-9303
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Cepeda A, Nowotny KM, Frankeberger J, Ramirez E, Rodriguez VE, Perdue T, Valdez A. Examination of multilevel domains of minority stress: Implications for drug use and mental and physical health among Latina women who have sex with women and men. PLoS One 2020; 15:e0230437. [PMID: 32214323 PMCID: PMC7098621 DOI: 10.1371/journal.pone.0230437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 03/01/2020] [Indexed: 11/19/2022] Open
Abstract
There has recently been growing attention and concern in the U.S. on the detrimental drug use and related health conditions impacting diverse sexual minority populations. While some evidence indicates that bisexual women are at increased risk of substance use, little attention has been given to disadvantaged and racial/ethnic minority bisexual women, who are particularly vulnerable to a complexity of stressors and risk. Using data from a 15-year longitudinal study in San Antonio, Texas, the current study examines drug use, incarceration histories, stressful life events, and infections among 206 young adult Mexican-American women who report engaging in sex with both men and women (WSWM) (n = 61) and those indicating having exclusively male sex partners (WSM) (n = 145). A bivariate analysis finds that WSWM experienced more frequent (p = 0.001) and longer total time incarcerated (p = 0.001), as well as exposure to more stressful life events (p = 0.003). WSWM also have higher rates of past 30 day injection drug use (p = 0.026) and related Hepatitis C Virus (HCV) infection (p = 0.001), as well as greater symptomatology associated with depression (p = 0.014), PTSD (p = 0.005), and suicidal ideation (p = 0.036). Findings indicate a significantly elevated risk profile for socio-economically marginalized WSWM. This knowledge is timely and central to policy discourse to develop interventions and health campaigns aimed at reducing and/or preventing further health disparities among this highly susceptible population of minority women.
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Affiliation(s)
- Alice Cepeda
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
- * E-mail:
| | - Kathryn M. Nowotny
- Department of Sociology, University of Miami, Miami, FL, United States of America
| | - Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States America
| | - Esmeralda Ramirez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
| | - Victoria E. Rodriguez
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, CA, United States America
| | - Tasha Perdue
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
| | - Avelardo Valdez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States of America
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Charlton BM, Everett BG, Light A, Jones RK, Janiak E, Gaskins AJ, Chavarro JE, Moseson H, Sarda V, Austin SB. Sexual Orientation Differences in Pregnancy and Abortion Across the Lifecourse. Womens Health Issues 2020; 30:65-72. [PMID: 31810786 PMCID: PMC7071993 DOI: 10.1016/j.whi.2019.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 10/21/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We examined sexual orientation-related differences in various pregnancy outcomes (e.g., teen pregnancy, abortion) across the lifespan. METHODS We collected data from 124,710 participants in three U.S. longitudinal cohort studies, the Nurses' Health Study 2 and 3 and Growing Up Today Study 1, followed from 1989 to 2017. Multivariate regression was used to calculate differences of each outcome-ever had pregnancy, teen pregnancy, ever had abortion, and age at first birth-by sexual orientation groups (e.g., heterosexual, mostly heterosexual, bisexual, lesbian), adjusting for potential confounders of age and race/ethnicity. RESULTS All sexual minority groups-except lesbians-were generally more likely than heterosexual peers to have a pregnancy, a teen pregnancy, and an abortion. For example, Growing Up Today Study 1 bisexual participants were three times as likely as heterosexuals to have had an abortion (risk ratio, 3.21; 95% confident interval, 1.94-5.34). Lesbian women in all of the cohorts were approximately half as likely to have a pregnancy compared with heterosexual women. Few sexual orientation group differences were detected in age at first birth. CONCLUSIONS The increased risk of unintended pregnancy among sexual minority women likely reflects structural barriers to sexual and reproductive health services. It is critical that sex education programs become inclusive of sexual minority individuals and medical education train health care providers to care for this population. Health care providers should not make harmful heteronormative assumptions about pregnant patients and providers must learn to take sexual histories as well as offer contraceptive counseling to all patients who want to prevent a pregnancy regardless of sexual orientation.
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Affiliation(s)
- Brittany M Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Bethany G Everett
- Department of Sociology, University of Utah, Salt Lake City, Salt Lake City, Utah
| | - Alexis Light
- Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, District of Columbia
| | - Rachel K Jones
- Research Division, Guttmacher Institute, New York, New York
| | - Elizabeth Janiak
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Planned Parenthood League of Massachusetts, Boston, Massachusetts
| | - Audrey J Gaskins
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jorge E Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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15
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Kessler R, Hinkle BT, Moyers A, Silverberg B. Adolescent Sexual Health: Identity, Risk, and Screening for Sexually Transmitted Infections. Prim Care 2020; 47:367-382. [PMID: 32423720 DOI: 10.1016/j.pop.2020.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Development of SOGIE (sexual orientation and gender identity and expression) is not unique to minority populations, as all adolescents grapple with their sexuality and identity. Health care providers straddle the unique positions of authority figure and advocate and can help these young people establish behaviors that will allow them to flourish as adults. This article discusses the appropriate language to use while conducting a sexual history, summarizes the epidemiologic data on sexually transmitted infections, and reviews the screening and reporting guidelines set forth by the United States Preventive Services Task Force and the Centers for Disease Control and Prevention.
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Affiliation(s)
- Roanna Kessler
- Johns Hopkins University Student Health and Wellness Center, Homewood Student Affairs, 1 East 31st Street, N200, Baltimore, MD 21218, USA
| | - B Tate Hinkle
- Total Healthcare at Russell Medical Center, 3504 Highway 280, Alexander City, AL 35010, USA; Department of Family Medicine, UAB Huntsville Regional Medical Campus, 301 Governors Drive SW, Huntsville, AL 35801, USA
| | - Amy Moyers
- Department of Family Medicine, WVU Medicine, 6040 University Town Center Drive, Morgantown, WV 26501, USA
| | - Benjamin Silverberg
- Department of Family Medicine, WVU Medicine, 6040 University Town Center Drive, Morgantown, WV 26501, USA; Department of Emergency Medicine, WVU Medicine, 1 Medical Center Drive, Box 9149, Morgantown, WV 26506, USA; Division of Physician Assistant Studies, Department of Human Performance, West Virginia University School of Medicine, 64 Medical Center Drive, Box 9226, Morgantown, WV 26506, USA.
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16
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Lippa RA. Interest, Personality, and Sexual Traits That Distinguish Heterosexual, Bisexual, and Homosexual Individuals: Are There Two Dimensions That Underlie Variations in Sexual Orientation? ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:607-622. [PMID: 31989410 DOI: 10.1007/s10508-020-01643-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 06/10/2023]
Abstract
A diverse U.S. sample comprising 1437 men and 1474 women was assessed on sexual orientation, masculinity-femininity of occupational preferences (MF-Occ), self-ascribed masculinity-femininity (Self-MF), Big Five personality traits, sex drive, and sociosexuality (positive attitudes toward uncommitted sex). Discriminant analyses explored which traits best distinguished self-identified heterosexual, bisexual, and homosexual individuals within each sex. These analyses correctly classified the sexual orientation of 55% of men and 60% of women, which was substantially better than a chance rate (33%) of assigning participants to one of three groups. For men, MF-Occ and Self-MF distinguished heterosexual, bisexual, and gay men, with heterosexual men most gender typical, gay men most gender atypical, and bisexual men intermediate. Independently, higher sex drive, sociosexuality, and neuroticism and lower conscientiousness distinguished bisexual men from other groups. For women, gender-related interests and Self-MF distinguished lesbians from other groups, with lesbians most gender atypical. Independently, higher sociosexuality, sex drive, and Self-MF distinguished non-heterosexual from heterosexual women. These findings suggest that variations in self-reported sexual orientation may be conceptualized in terms of two broad underlying individual difference dimensions, which differ somewhat for men and women: one linked to gender typicality versus gender atypicality and the other linked to sex drive, sociosexuality, and various personality traits.
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Affiliation(s)
- Richard A Lippa
- Psychology Department, California State University, Fullerton, Fullerton, CA, 92836, USA.
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17
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Souto Pereira S, Swainston K, Becker S. The discursive construction of low-risk to sexually transmitted diseases between women who are sexually active with women. CULTURE, HEALTH & SEXUALITY 2019; 21:1309-1321. [PMID: 30632939 DOI: 10.1080/13691058.2018.1554188] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
This paper uses a discursive analytical method to explore dominant discourses concerning the sexual health of women who have sex with women. In-depth interviews were conducted with a cross-cultural sample of women from England and Brazil. Sex between women was discursively constructed as 'safe', and women who have sex with women were seen as being at low to negligible risk of contracting/transmitting sexually transmitted infections. Analysis identified two discourses underlying these constructions: a binaries discourse which focused on dichotomies of gender, sexuality and risk; and a sexual double-standard discourse, which focused on the positioning of sex between women as safe and the use of barrier methods of protection as indicative of not engaging in or fully enjoying the sexual act.
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Affiliation(s)
- Sandra Souto Pereira
- School of Social Sciences, Humanities and Law, Teeside University, Middlesbrough, UK
| | - Katherine Swainston
- School of Social Sciences, Humanities and Law, Teeside University, Middlesbrough, UK
| | - Sue Becker
- School of Social Sciences, Bishop Grosseteste University, Lincoln, UK
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18
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Replicating the relationships between Dark Triad traits and female mate-competition tactics in undergraduate women. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2019.04.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Jahn JL, Bishop RA, Tan ASL, Agénor M. Patient-Provider Sexually Transmitted Infection Prevention Communication among Young Adult Sexual Minority Cisgender Women and Nonbinary Assigned Female at Birth Individuals. Womens Health Issues 2019; 29:308-314. [PMID: 30819413 DOI: 10.1016/j.whi.2019.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Health care providers are an important source of sexually transmitted infection (STI) prevention information for young adult sexual minority women (SMW). However, very few studies have described patient-provider STI communication in this understudied and underserved population. We explore sexual minority women's experiences communicating with health care providers about sexual health, with particular attention to STI prevention, to inform programs and practices that address their unique needs and concerns. METHODS We conducted 29 in-depth interviews with sexual minority cisgender women and nonbinary assigned female at birth (AFAB) individuals aged 18-36 years. The sample included White (55%), Asian (31%), Black (17.2%), and Latina (3.4%) participants. We used thematic analysis with deductive and inductive coding to identify themes related to patient-provider STI prevention communication. RESULTS Heteronormative health care provider assumptions inhibited participants' willingness to disclose their sexual orientation and discuss sexual health issues with providers. Most sexual health conversations focused on pregnancy and contraception, which many felt was irrelevant to them, and limited STI prevention recommendations to condom use. Participants reported that some providers lacked medical knowledge on AFAB-to-AFAB STI transmission and were not able to provide relevant STI prevention information. Providers' bias related to gender identity and race/ethnicity furthered some participants' mistrust generated from providers' heteronormative assumptions. CONCLUSIONS Our study describes several barriers that AFAB sexual minorities felt inhibited their patient-provider sexual health communication. Interventions are needed to improve patient-provider STI prevention conversations with AFAB sexual minorities so they can access the sexual health information they need to effectively protect themselves from STIs.
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Affiliation(s)
- Jaquelyn L Jahn
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Rachel A Bishop
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; MassHealth, Office of Medicaid, Executive Office of Health & Human Services, Commonwealth of Massachusetts, Boston, Massachusetts
| | - Andy S L Tan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Madina Agénor
- Department of Community Health, Tufts University, Medford, Massachusetts
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20
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Luoto S, Krams I, Rantala MJ. A Life History Approach to the Female Sexual Orientation Spectrum: Evolution, Development, Causal Mechanisms, and Health. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1273-1308. [PMID: 30229521 DOI: 10.1007/s10508-018-1261-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 05/29/2018] [Accepted: 06/14/2018] [Indexed: 05/12/2023]
Abstract
Women's capacity for sexual fluidity is at least as interesting a phenomenon from the point of view of evolutionary biology and behavioral endocrinology as exclusively homosexual orientation. Evolutionary hypotheses for female nonheterosexuality have failed to fully account for the existence of these different categories of nonheterosexual women, while also overlooking broader data on the causal mechanisms, physiology, ontogeny, and phylogeny of female nonheterosexuality. We review the evolutionary-developmental origins of various phenotypes in the female sexual orientation spectrum using the synergistic approach of Tinbergen's four questions. We also present femme-specific and butch-specific hypotheses at proximate and ultimate levels of analysis. This review article indicates that various nonheterosexual female phenotypes emerge from and contribute to hormonally mediated fast life history strategies. Life history theory provides a biobehavioral explanatory framework for nonheterosexual women's masculinized body morphology, psychological dispositions, and their elevated likelihood of experiencing violence, substance use, obesity, teenage pregnancy, and lower general health. This pattern of life outcomes can create a feedback loop of environmental unpredictability and harshness which destabilizes intrauterine hormonal conditions in mothers, leading to a greater likelihood of fast life history strategies, global health problems, and nonheterosexual preferences in female offspring. We further explore the potential of female nonheterosexuality to function as an alloparental buffer that enables masculinizing alleles to execute their characteristic fast life history strategies as they appear in the female and the male phenotype. Synthesizing life history theory with the female sexual orientation spectrum enriches existing scientific knowledge on the evolutionary-developmental mechanisms of human sex differences.
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Affiliation(s)
- Severi Luoto
- English, Drama and Writing Studies, University of Auckland, Arts 1, Building 206, Room 616, 14A Symonds St., Auckland, 1010, New Zealand.
- School of Psychology, University of Auckland, Auckland, New Zealand.
| | - Indrikis Krams
- Department of Zoology and Animal Ecology, University of Latvia, Riga, Latvia
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Markus J Rantala
- Department of Biology & Turku Brain and Mind Center, University of Turku, Turku, Finland
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21
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Paul Poteat V, Russell ST, Dewaele A. Sexual Health Risk Behavior Disparities Among Male and Female Adolescents Using Identity and Behavior Indicators of Sexual Orientation. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1087-1097. [PMID: 29204816 PMCID: PMC10388691 DOI: 10.1007/s10508-017-1082-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/05/2017] [Accepted: 09/12/2017] [Indexed: 05/15/2023]
Abstract
Sexual minority adolescent sexual risk behavior studies often overlook young women, do not consider behavior- and identity-based sexual orientation indicators in combination, and focus mainly on condomless sex. We examined multiple risk behaviors in a large sample of adolescent young men and women using combined behavior- and identity-based indices. The 2015 Dane County Youth Assessment data included 4734 students in 22 high schools who had ever voluntarily engaged in sexual contact (51.7% male; 76.0% White, non-Hispanic). Items assessed having sex with unfamiliar partners, sex while using substances, using protection, and STI testing. Logistic regressions tested for disparities based on combined identity- and behavior-based sexual orientation indicators. For both young men and women, youth who reported heterosexual or questioning identities-but who had sex with same-sex partners-were at consistently greater risk than heterosexual youth with only different-sex partners. Also, for both young men and women, bisexuals with partners of both sexes more consistently reported higher risk than heterosexual youth than did bisexuals with only different-sex partners. Risk behavior for gay young men who had sex only with men mirrored those in extant literature. Risk levels differed for specific groups of sexual minority young women, thus deserving further attention. Findings underscore the need for sexual health research to consider sexual orientation in a more multidimensional manner.
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Affiliation(s)
- V Paul Poteat
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Campion Hall 307, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA.
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas, Austin, TX, USA
| | - Alexis Dewaele
- Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Sexual and Gender Minority Adolescents: Meeting the Needs of Our LGBTQ Patients and Their Families. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2019. [DOI: 10.1016/j.cpem.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Andrade J, Ignácio MAO, Freitas APFD, Parada CMGDL, Duarte MTC. [Vulnerability to sexually transmitted infections of women who have sex with women]. CIENCIA & SAUDE COLETIVA 2019; 25:3809-3819. [PMID: 32997014 DOI: 10.1590/1413-812320202510.03522019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/22/2019] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to assess the degree of vulnerability to sexually transmitted infections of women who have sex with women. It involved a cross-sectional study of 150 women between 2015 and 2017. A structured questionnaire was applied, and a gynecological examination was performed to diagnose Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and papillomavirus. Blood tests were conducted to detect HIV, hepatitis B and syphilis. The outcome variable was sexual infection and the independent variables comprised the vulnerability level in the individual, social and programmatic dimensions. Data analyses were performed through logistic regression. The results showed a high prevalence of infections (47.3%) and only variables of individual vulnerability were associated with the outcome. The incidence of infection was four times higher among women who had had prior infections. The fact of never having had a blood test tripled the chance of having sexually transmitted infections. The fact of also having sexual intercourse with men in the previous 12-month-period increased the risk of the outcome by a factor of approximately nine. The conclusion drawn is that these women are vulnerable to sexually transmitted infections due to their individual vulnerability.
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Affiliation(s)
- Juliane Andrade
- Departamento de Enfermagem, Faculdade de Ciências da Saúde, Universidade de Brasília. Campus Universitário Darcy Ribeiro s/n, Asa Norte. 70910-900 Brasília DF Brasil.
| | - Mariana Alice Oliveira Ignácio
- Departamento de Saúde Pública, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp). Botucatu SP Brasil
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25
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Medina-Perucha L, Family H, Scott J, Chapman S, Dack C. Factors Associated with Sexual Risks and Risk of STIs, HIV and Other Blood-Borne Viruses Among Women Using Heroin and Other Drugs: A Systematic Literature Review. AIDS Behav 2019; 23:222-251. [PMID: 30073636 PMCID: PMC6342849 DOI: 10.1007/s10461-018-2238-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This systematic literature review identified factors associated with sexual risks related to sexually transmitted infections (STI), HIV and other blood-borne viruses (BBV) among women using heroin and other drugs. The search strategy included five databases (PubMed, EMBASE, PsycNET, Web of Science, Scopus), and PsycEXTRA for grey literature. Out of the 12,135 publications screened, 30 peer-reviewed articles were included. Most publications were cross-sectional (n = 25), quantitative (n = 23) and included 11,305 women. Factors identified were: (1) socio-demographics; (2) gender roles and violence against women; (3) substance use; (4) transactional sex; (5) partner characteristics, partner's drug use, and context of sex; (6) preferences, negotiation and availability of condoms; (7) HIV status and STIs; (8) number of sexual partners; (9) love and trust; (10) reproductive health and motherhood; and (11) risk awareness and perception of control. Overall, this review highlights important implications for future research and practice, and provides evidence for developing STI/BBV preventive strategies.
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Affiliation(s)
- L Medina-Perucha
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK.
- 5 West, 2.52, Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK.
| | - H Family
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK
| | - J Scott
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK
| | - S Chapman
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK
| | - C Dack
- Department of Psychology, University of Bath, Bath, UK
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26
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Kowalczyk R, Nowosielski K. Impact of social factors and sexual behaviors on the knowledge of sexually transmitted infections among women who have sex with women/women who have sex with women and men. Int J STD AIDS 2018; 30:163-172. [PMID: 30348067 DOI: 10.1177/0956462418802736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although heterosexual individuals' knowledge of sexually transmitted infections (STIs) has been examined, no studies have been conducted in Poland of the STI knowledge in women who have sex with women (WSW) and women who have sex with women and men (WSWM). We enrolled a group of 146 WSW and 113 WSWM and asked them to complete a study questionnaire that contained items about socioeconomic factors, sexual behaviors, and STI knowledge. The level of STI knowledge among the studied WSW was insufficient. The frequency of correct answers was higher in WSWM. A multivariate regression model revealed that only the higher importance of sex to the respondents ( F(1) = 4.31, p = 0.04) and a higher number of same-sex sexual partners within the last 12 months ( F(1) = 14.86, p = 0.0001) influenced the level of STI knowledge. The results of the study allowed us to conclude that WSW have insufficient STI knowledge, whereas WSWM have better knowledge, and this is influenced by awareness that STI risk is not associated with the partner's gender, age, importance of sex, sexual behaviors, and openness to discussing STIs with a sexual partner.
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Affiliation(s)
- Robert Kowalczyk
- 1 Department of Sexology, Andrzej Frycz Modrzewski Cracow University, Kraków, Poland
| | - Krzysztof Nowosielski
- 2 Department of Sexology and Family Planning, Medical College in Sosnowiec, Sosnowiec, Poland
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27
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Jones RK, Jerman J, Charlton BM. Sexual Orientation and Exposure to Violence Among U.S. Patients Undergoing Abortion. Obstet Gynecol 2018; 132:605-611. [PMID: 30095763 PMCID: PMC10552916 DOI: 10.1097/aog.0000000000002732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the characteristics of patients undergoing abortion in the United States according to sexual orientation and exposure to sexual and physical violence. METHODS Data for this observational study come from the Guttmacher Institute's 2014 Abortion Patient Survey, which obtained information from 8,380 individuals obtaining abortions at nonhospital facilities in the United States; 7,656 of those (91%) provided information on sexual orientation identity. We used simple logistic regression to assess differences between heterosexuals and three sexual minority groups-bisexual, lesbian, and something else-according to demographic characteristics and exposure to sexual and physical violence. Multivariate logistic regression was used to assess associations between sexual orientation and exposure to violence. RESULTS Among patients undergoing abortion in 2014, 4.1% identified as bisexual (n=316), 1.1% as something else (n=81), and 0.4% as lesbian (n=28); 94.4% identified as heterosexual (n=7,231). Similar proportions of lesbian and heterosexual respondents reported a prior birth (53.6% and 58.2%, P=.62), whereas respondents who identified as something else were more likely to report having had a prior abortion (58.0% vs 43.9%, P=.01). Exposure to sexual violence was substantially and significantly higher among all three sexual minority groups compared with heterosexuals, and lesbian and bisexual respondents were also more likely than their heterosexual peers to report exposure to physical violence by the man involved in the pregnancy (33.3% and 8.7% vs 3.6%, P<.001). CONCLUSION No patient should be presumed to be heterosexual. Understanding the disproportionate role of sexual violence in unintended pregnancies among sexual minorities may aid in the design of interventions and clinical guidelines that address the needs of sexual minority patients.
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Affiliation(s)
- Rachel K Jones
- Guttmacher Institute, New York, New York; and Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston Children's Hospital, Boston, Massachusetts
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Logie CH, Lacombe-Duncan A, Wang Y, Kaida A, de Pokomandy A, Webster K, Conway T, Loutfy M. Sexual Orientation Differences in Health and Wellbeing Among Women Living with HIV in Canada: Findings from a National Cohort Study. AIDS Behav 2018; 22:1987-2001. [PMID: 28444470 DOI: 10.1007/s10461-017-1781-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sexual orientation differences in health and wellbeing among women living with HIV (WLH) are underexplored. Limited research available, however, suggests that sexual minority WLH may experience barriers to HIV care. Cross-sectional baseline data was analyzed from a Canadian cohort study with WLH (sexual minority women [SMW]: n = 180; heterosexual women: n = 1240). SMW (median age 38 years, IQR 13) included bisexual (58.9%), lesbian (17.8%) and other sexualities (23.3%). In multivariable analyses adjusting for age, poverty, education, and ethnicity, SMW identity was associated with increased odds of: clinical (80% vs. 100% antiretroviral adherence), intrapersonal (previous/current injection drug use [IDU] vs. no IDU history, depression, lower resilience), interpersonal (childhood abuse, sex work, adulthood abuse), and structural (HIV support services barriers, unstable housing, racial discrimination, gender discrimination) factors in comparison with heterosexual identity. Sexual minority WLH experience social and health disparities relative to heterosexual WLH, highlighting the need for interventions to promote health equity.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, USA.
- Women's College Research Institute, Women's College Hospital, Toronto, ON, USA.
| | - Ashley Lacombe-Duncan
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, USA
| | - Ying Wang
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, USA
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, USA
| | - Alexandra de Pokomandy
- Department of Family Medicine, McGill University, Montreal, QC, USA
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, USA
| | - Kath Webster
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, USA
| | - Tracey Conway
- Women's College Research Institute, Women's College Hospital, Toronto, ON, USA
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, ON, USA
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, USA
- Department of Medicine, University of Toronto, Toronto, ON, USA
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Palma DM, Orcasita LT. “La solución es la tijera”: Programa de Salud Sexual para Mujeres Lesbianas y Bisexuales. PSICOLOGIA: TEORIA E PESQUISA 2018. [DOI: 10.1590/0102.3772e34419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMEN La inclusión de las mujeres lesbianas y bisexuales en las agendas de promoción de la salud sexual es escasa. Sin embargo, los riesgos en sus prácticas sexuales han sido reconocidos científicamente. Este artículo presenta los resultados principales del programa de intervención “La solución es la tijera” dirigido a mujeres lesbianas y bisexuales jóvenes de Cali, Colombia. Participaron 23 mujeres entre los 18 y los 25 años de edad (X= 21.7; DS=1.78). La evaluación se realizó de manera pre- post a través de una metodología mixta. Se encontró un cambio significativo en los niveles de conocimientos y las actitudes frente al VIH. Asimismo, se reportó el fortalecimiento de la identidad, el empoderamiento en su sexualidad y los conocimientos sobre derechos sexuales y reproductivos.
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Stoffel C, Carpenter E, Everett B, Higgins J, Haider S. Family Planning for Sexual Minority Women. Semin Reprod Med 2017; 35:460-468. [PMID: 29073685 DOI: 10.1055/s-0037-1604456] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractThe family planning needs of sexual minority women (SMW) are an understudied but growing area of research. SMW have family planning needs, both similar to and distinct from their exclusively heterosexual peers. Specifically, SMW experience unintended pregnancies at higher rates than their exclusively heterosexual peers, but factors that increase this risk are not well understood. Contraception use is not uncommon among SMW, but lesbian women are less likely to use contraception than bisexual or exclusively heterosexual women. High rates of unintended pregnancy suggest contraception is underused among SMW. Contraception counseling guidelines specific to SMW do not yet exist, but greater adoption of current best practices is likely to meet the needs of SMW. SMW may have unique needs for their planned pregnancies as well, for which obstetrics and gynecology (Ob/Gyn) providers should provide care and referrals. In general, understandings of the distinct family planning needs for SMW are limited and further research is needed, with particular attention to issues of overlapping health disparities related to status as a SMW and other factors such as race/ethnicity that may add additional layers of stigma and discrimination. Clinical resources are needed to help Ob/Gyns make their practice more welcoming to the needs of SMW.
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Affiliation(s)
- Cynthia Stoffel
- Department of Academic Internal Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Emma Carpenter
- Madison School of Social Work, University of Wisconsin, Madison, Wisconsin
| | - Bethany Everett
- Department of Sociology, University of Utah, Salt Lake City, Utah
| | - Jenny Higgins
- Department of Gender and Women's Studies, University of Wisconsin-Madison, Madison, Wisconsin
| | - Sadia Haider
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
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31
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Palma DM, Orcasita LT. Considerations for the design of Human Immunodeficiency Virus (HIV) prevention programs for lesbian and bisexual women. ACTA ACUST UNITED AC 2017. [DOI: 10.1590/1807-57622016.0790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Several strategies and guidelines for HIV prevention in different population groups have been established throughout the epidemic. However, there is an urgent need to include lesbian and bisexual women (LB women) in prevention programs and address their particular health care needs. This paper discusses key aspects that must be considered in the design of HIV prevention programs oriented toward this specific population. Due to the lack of research assessing prevention strategies for LB women, these reflections emerged by reviewing literature in similar groups and by the direct work of the authors within this group. Their inclusion in the HIV prevention agenda is essential to safeguard their right to health care in terms of receiving accurate information about sexuality and health, participating in health care programs and being treated equally and without any discrimination.
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Semenyna SW, Belu CF, Vasey PL, Lynne Honey P. Not Straight and Not Straightforward: the Relationships Between Sexual Orientation, Sociosexuality, and Dark Triad Traits in Women. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2017. [DOI: 10.1007/s40806-017-0111-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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33
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Bradshaw CS, Sobel JD. Current Treatment of Bacterial Vaginosis-Limitations and Need for Innovation. J Infect Dis 2017; 214 Suppl 1:S14-20. [PMID: 27449869 DOI: 10.1093/infdis/jiw159] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Practitioners and patients alike widely recognize the limitations of current therapeutic approaches to the treatment of bacterial vaginosis (BV). Options remain extremely limited, and our inability to prevent the frequently, often relentless symptomatic recurrences of BV and to reduce serious sequelae such as preterm delivery, remains an acknowledged but unresolved shortcoming. Our incomplete understanding of the pathophysiology of this unique form of vaginal dysbiosis has been a significant impediment to developing optimal treatment and prevention approaches. New drugs have not been forthcoming and are not likely to be available in the immediate future; hence, reliance on the optimal use of available agents has become essential as improvised often unproven regimens are implemented. In this review, we will explore the limitations of currently recommended therapies, with a particular focus on the contribution of reinfection and pathogen persistence to BV recurrence, and the development of interventions that target these mechanisms. Ultimately, to achieve sustained cure and effectiveness against BV-associated sequelae, it is possible that we will need approaches that combine antimicrobials with biofilm-disrupting agents and partner treatments in those at risk of reinfection.
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Affiliation(s)
- Catriona S Bradshaw
- Melbourne Sexual Health Centre Central Clinical School, Monash University, Clayton, Australia
| | - Jack D Sobel
- Division of Infectious Diseases, Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan
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Branstetter AJ, McRee AL, Reiter PL. Correlates of Human Papillomavirus Infection Among a National Sample of Sexual Minority Women. J Womens Health (Larchmt) 2017; 26:1004-1011. [PMID: 28486052 DOI: 10.1089/jwh.2016.6177] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Many sexual minority women are infected with human papillomavirus (HPV), yet little is known about correlates of HPV infection among this population. MATERIALS AND METHODS We analyzed data from a national sample of sexual minority women (i.e., women who either reported a history of female sexual partners or identified as nonheterosexual) aged 20-59 from the 2003 to 2012 National Health and Nutrition Examination Survey (n = 830). Weighted logistic regression identified correlates of infection with any HPV type and infection with a high-risk HPV type. RESULTS About 53% of women were infected with any HPV type, and about 37% were infected with a high-risk HPV type. Women who reported five or more sexual partners during their lifetime (adjusted odds ratio [aOR] = 5.07, 95% confidence interval [CI]: 2.26-11.42) were more likely to be infected with a high-risk HPV type. Compared to women aged 20-29, women aged 40-49 (aOR = 0.51, 95% CI: 0.32-0.81) or 50-59 (aOR = 0.27, 95% CI: 0.14-0.53) were less likely to be infected with a high-risk HPV type, as were women who were married or living with a partner (aOR = 0.62, 95% CI: 0.44-0.89). Mostly similar correlates were identified for infection with any HPV type, although infection with any HPV type was also less common among women who identified as lesbian compared to those who identified as heterosexual (aOR = 0.38, 95% CI: 0.21-0.68). CONCLUSIONS Demographic and health-related characteristics were associated with HPV infection outcomes. Findings can inform HPV prevention efforts for sexual minority women by providing information about risk factors and subgroups at particular risk for infection.
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Abstract
Adolescents are at high risk for acquisition and transmission of sexually transmitted infections (STI) secondary to both cognitive and biological susceptibility. The prevention, diagnosis, and treatment of STIs are a critical part of adolescent health care. This article discusses the most common bacterial, parasitic, and viral STIs encountered in this age group with an emphasis on new guidelines for screening and management.
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36
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Barman-Adhikari A, Hsu HT, Begun S, Portillo AP, Rice E. Condomless Sex Among Homeless Youth: The Role of Multidimensional Social Norms and Gender. AIDS Behav 2017; 21:688-702. [PMID: 27885551 DOI: 10.1007/s10461-016-1624-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Most studies of condomless sex among homeless youth have focused on peer norms, while excluding other potentially pertinent influences. This study explored how different types of relationships contributed to norms about condomless sex and whether such norms were associated with engagement in condomless sex among homeless youth. Additionally, because recent work has noted gender differences in social networks of male and female homeless youth, gender differences in social network norms of condomless sex were also assessed. Egocentric network data were collected from homeless youth accessing services at two drop-in centers in Los Angeles, CA (N = 976). Multivariate analyses (non-stratified and stratified by gender) assessed associations between descriptive, injunctive, and communicative norms and participants' engagement in condomless sex. Multivariate analyses indicated that perception of peer condom use and communication with sexual partners were significantly associated with not engaging in condomless sex. These relationships, however, varied by gender. Implications for interventions are discussed.
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Affiliation(s)
- Anamika Barman-Adhikari
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO, 80208, USA.
| | - Hsun-Ta Hsu
- School of Social Work, University of Missouri, Columbia, MO, USA
| | - Stephanie Begun
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO, 80208, USA
| | - Andrea Perez Portillo
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO, 80208, USA
| | - Eric Rice
- School of Social Work, University of Southern California, Los Angeles, CA, USA
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37
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Hodson K, Meads C, Bewley S. Lesbian and bisexual women's likelihood of becoming pregnant: a systematic review and meta-analysis. BJOG 2017; 124:393-402. [PMID: 27981741 PMCID: PMC5299536 DOI: 10.1111/1471-0528.14449] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Few data exist regarding pregnancy in lesbian and bisexual (LB) women. OBJECTIVES To determine the likelihood of LB women becoming pregnant, naturally or assisted, in comparison with heterosexual women SEARCH STRATEGY: Systematic review of papers published 1 January 2000 to 23 June 2015. SELECTION CRITERIA Studies contained details of pregnancy rates among LB women compared with heterosexual women. No restriction on study design. DATA COLLECTION AND ANALYSIS Inclusion decisions, data extraction and quality assessment were conducted in duplicate. Meta-analyses were carried out, with subgroups as appropriate. MAIN RESULTS Of 6859 papers identified, 104 full-text articles were requested, 30 papers (28 studies) were included. The odds ratio (OR) of ever being pregnant was 0.19 (95% CI 0.18-0.21) in lesbian women and 1.22 (95% CI 1.15-1.29) in bisexual women compared with heterosexual women. In the general population, the odds ratio for pregnancy was nine-fold lower among lesbian women and over two-fold lower among bisexual women (0.12 [95% CI 0.12-0.13] and 0.50 [95% CI 0.45-0.55], respectively). Odds ratios for pregnancy were higher for both LB adolescents (1.37 [95% CI 1.18-1.59] and 1.98 [95% CI 1.85, 2.13], respectively). There were inconsistent results regarding abortion rates. Lower rates of previous pregnancies were found in lesbian women undergoing artificial insemination (OR 0.17 [95% CI 0.11-0.26]) but there were higher assisted reproduction success rates compared with heterosexual women (OR 1.56 [95% CI 1.24-1.96]). CONCLUSIONS Heterosexuality must not be assumed in adolescents, as LB adolescents are at greater risk of unwanted pregnancies and terminations. Clinicians should provide appropriate information to all women, without assumptions about LB patients' desire for, or rejection of, fertility and childbearing. TWEETABLE ABSTRACT Review of likelihood of LB women becoming pregnant: LB teenagers at greater risk of unwanted pregnancies.
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Affiliation(s)
| | - C Meads
- Department of Health, Social Care and EducationAnglia Ruskin UniversityCambridgeUK
| | - S Bewley
- Division of Women's HealthWomen's Health Academic CentreKing's College London and King's Health PartnersSt Thomas’ Hospital CampusLondonUK
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38
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Abstract
Infectious disease has a major impact on the health outcomes of underserved populations and is reported at significantly higher rates among these populations compared with the general population. Overcoming barriers and obstacles to health care access is key to addressing the disparity regarding the prevalence of infectious disease. Enhancing cultural competency and educating practitioners about underserved populations' basic health needs; optimizing health insurance for the underserved; increasing community resources; and improving access to comprehensive, continuous, compassionate, and coordinated health care are strategies for diminishing the burden of infectious disease in underserved populations.
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Affiliation(s)
- Samuel Neil Grief
- Department of Family Medicine, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, IL 60612, USA.
| | - John Paul Miller
- Bakersfield Memorial Family Medicine Residency Program, Department of Family Medicine, University of California Irvine School of Medicine, 420 34th Street, Bakersfield, CA 93301, USA
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39
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Logie CH, Lacombe-Duncan A, MacKenzie RK, Poteat T. Minority Stress and Safer Sex Practices Among Sexual Minority Women in Toronto, Canada: Results from a Cross-Sectional Internet-Based Survey. LGBT Health 2016; 3:407-415. [PMID: 27792468 DOI: 10.1089/lgbt.2016.0005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Sexual stigma is a chronic stressor that enhances vulnerability to mental health disparities among lesbian, gay, bisexual, and queer people. Sexual stigma has also been associated with reduced uptake of safer sex practices, such as condom use, among gay and bisexual men. Scant research has examined the relationship between sexual stigma and safer sex practices among sexual minority women (SMW), including lesbian, bisexual, and queer women. METHODS We explored associations between sexual stigma and safer sex practices among SMW. We also tested the interaction between sexual stigma, social support, and resilient coping in this relationship. A cross-sectional internet-based survey was administered to SMW in Toronto, Canada. RESULTS Among 388 participants with complete measurement data, simple linear regression indicated both perceived and enacted sexual stigma were positively associated with uptake of safer sex practices. In multivariable analyses, significant interactions were found between perceived sexual stigma and resilient coping, and between enacted sexual stigma and social support. At low levels of resilient coping, higher levels of perceived sexual stigma were associated with fewer safer sex practices, while at high levels of resilient coping the relationship was reversed. At low levels of social support, higher levels of enacted sexual stigma were associated with fewer safer sex practices, while at high levels of social support the relationship was reversed. CONCLUSIONS These findings document complex relationships between sexual stigma dimensions, coping, social support, and safer sex practices. Understanding the role these variables play in uptake of safer sex practices can inform sexual health interventions tailored for SMW.
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Affiliation(s)
- Carmen H Logie
- 1 Factor-Inwentash Faculty of Social Work, University of Toronto , Toronto, Canada .,2 Women's College Research Institute , Women's College Hospital, Toronto, Canada
| | | | - Rachel K MacKenzie
- 3 Dalla Lana School of Public Health , University of Toronto, Toronto, Canada
| | - Tonia Poteat
- 4 Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University , Baltimore, Maryland
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Arbeit MR, Fisher CB, Macapagal K, Mustanski B. Bisexual Invisibility and the Sexual Health Needs of Adolescent Girls. LGBT Health 2016; 3:342-9. [PMID: 27604053 DOI: 10.1089/lgbt.2016.0035] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The purpose of this study was to analyze bisexual female youth perspectives on their experiences accessing sexual health information and services provided by a doctor, nurse, or counselor. Specifically, we sought to: (1) understand how youth perceptions of providers' attitudes and behaviors affect their seeking and obtaining sexual health information and services; (2) examine how social stigmas within the family context might be associated with barriers to sexual health information and services; and (3) assess school-based sources of sexual health information. METHOD We utilized a mixed-method study design. Data from bisexual female youth were collected through an online questionnaire and asynchronous online focus groups addressing lesbian, gay, bisexual, and transgender health and HIV prevention. Data were analyzed with descriptive statistics and thematic analysis. RESULTS Barriers to sexual healthcare included judgmental attitudes and assumptions of patient heterosexuality among healthcare providers, and missed opportunities for HIV and sexually transmitted infections (STI) testing. Bisexual stigma within families was associated with restricted youth openness with providers, suggesting fear of disclosure to parent or guardian. School-based sexual health education was limited by a restrictive focus on abstinence and condoms and the exclusion of STI risk information relevant to sex between women. CONCLUSION We recommend that practitioners integrate nonjudgmental questions regarding bisexuality into standard contraceptive and sexual health practices involving female youth, including discussion of HIV and STI risk reduction methods. Further support for bisexual health among adolescent girls can come through addressing stigmas of female bisexuality, increasing sensitivity to privacy while engaging parents, and expanding the reach of school-based sexual health education.
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Affiliation(s)
- Miriam R Arbeit
- 1 Center for Ethics Education, Fordham University , New York, New York
| | - Celia B Fisher
- 1 Center for Ethics Education, Fordham University , New York, New York
| | - Kathryn Macapagal
- 2 Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University , Chicago, Illinois
| | - Brian Mustanski
- 2 Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University , Chicago, Illinois
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Anxiety and Depressive Symptoms Among People Living with HIV and Childhood Sexual Abuse: The Role of Shame and Posttraumatic Growth. AIDS Behav 2016; 20:1609-20. [PMID: 26837633 DOI: 10.1007/s10461-016-1298-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA.
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42
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Ybarra ML, Mitchell KJ. A National Study of Lesbian, Gay, Bisexual (LGB), and Non-LGB Youth Sexual Behavior Online and In-Person. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1357-72. [PMID: 25894645 PMCID: PMC4609578 DOI: 10.1007/s10508-015-0491-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 01/16/2015] [Accepted: 01/17/2015] [Indexed: 05/11/2023]
Abstract
Online and in-person sexual behaviors of cisgender lesbian, gay, queer, bisexual, heterosexual, questioning, unsure, and youth of other sexual identities were examined using data from the Teen Health and Technology study. Data were collected online between August 2010 and January 2011 from 5,078 youth 13-18 years old. Results suggested that, depending on sexual identity, between 4-35 % of youth had sexual conversations and 2-24 % shared sexual photos with someone online in the past year. Among the 22 % of youth who had oral, vaginal, and/or anal sex, between 5-30 % met one of their two most recent sexual partners online. Inconsistent condom use was associated with increased odds of meeting one's most recent partner online for heterosexual adolescent men. For gay and queer adolescent men, having an older partner, a partner with a lifetime history of sexually transmitted infections (STI), and concurrent sex partners were each significantly associated with increased odds of having met one's most recent sex partner online. None of the examined characteristics significantly predicted meeting one's most recent sexual partner online versus in-person for heterosexual; bisexual; or gay, lesbian, and queer women. The Internet is not replacing in-person exploration and expression of one's sexuality and meeting sexual partners online appears to be uncommon in adolescence across sexual identities. Healthy sexuality programming that acknowledges some youth are meeting partners online is warranted, but this should not be a main focal point. Instead, inclusive STI prevention programming that provides skills to reduce risk when engaging in all types of sex is critical.
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Affiliation(s)
- Michele L Ybarra
- Center for Innovative Public Health Research, 555 El Camino Real #A347, San Clemente, CA, 92672, USA.
| | - Kimberly J Mitchell
- Crimes Against Children Research Center, University of New Hampshire, Durham, NH, USA
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43
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Evans MGB, Cloete A, Zungu N, Simbayi LC. HIV Risk Among Men Who Have Sex With Men, Women Who Have Sex With Women, Lesbian, Gay, Bisexual and Transgender Populations in South Africa: A Mini-Review. Open AIDS J 2016; 10:49-64. [PMID: 27347271 PMCID: PMC4893624 DOI: 10.2174/1874613601610010049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/10/2015] [Accepted: 10/12/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The HIV epidemic in South Africa is characterized mainly by heterosexual transmission. Recently, the importance of targeting key populations and marginalized groups, including men who have sex with men (MSM) and transgender people, has been added to the national agenda. OBJECTIVES This mini-review explores the current state of empirical research on HIV risk and MSM, women who have sex with women (WSW), lesbian, gay, bisexual and transgender (LGBT) populations in South Africa in order to assess the current state of research and identify gaps in the literature. METHOD Peer-reviewed empirical social and behavioral articles on HIV prevalence and risk focusing on MSM, WSW, and LGBT populations published since 2006 were included in this mini-review. RESULTS In total 35 articles were included: 30 on MSM, gay, and/or bisexual male-identified populations, three on WSW, lesbian, and/or bisexual female-identified populations, two on LGB youth, and none on transgender populations. CONCLUSION Despite South Africa being the country with the largest number of people living with HIV in the world, there is a limited amount of research in South Africa on HIV and non-normative gender identities and sexualities, especially WSW, lesbian, and/or bisexual female-identified populations, transgender populations, and LGB youth. Research with MSM, WSW, and LGBT populations should be prioritized in South Africa in order to appropriately inform HIV prevention strategies that meet the specific needs of these marginalized groups.
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Affiliation(s)
- Meredith G. B. Evans
- HUMA (Institute for Humanities in Africa) and Department of Sociology, University of Cape Town, Cape Town, South Africa
| | - Allanise Cloete
- HAST (HIV/AIDS, STIs and TB) Program, Human Sciences Research Council, Cape Town, South Africa
| | - Nompumelelo Zungu
- HAST (HIV/AIDS, STIs and TB) Program, Human Sciences Research Council, Cape Town, South Africa
| | - Leickness C. Simbayi
- HAST (HIV/AIDS, STIs and TB) Program, Human Sciences Research Council, Cape Town, South Africa
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
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44
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Bilardi J, Walker S, McNair R, Mooney-Somers J, Temple-Smith M, Bellhouse C, Fairley C, Chen M, Bradshaw C. Women's Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study. PLoS One 2016; 11:e0151794. [PMID: 27010725 PMCID: PMC4807032 DOI: 10.1371/journal.pone.0151794] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/17/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Few data are available on how women manage recurring bacterial vaginosis (BV) and their experiences of the clinical care of this condition. This study aimed to explore women's recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV. METHODS A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews. RESULTS The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women's frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching. CONCLUSION In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.
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Affiliation(s)
- Jade Bilardi
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sandra Walker
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Ruth McNair
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Julie Mooney-Somers
- Centre for Values, Ethics and the Law in Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Clare Bellhouse
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Christopher Fairley
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Marcus Chen
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Catriona Bradshaw
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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45
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Bilardi J, Walker S, Mooney-Somers J, Temple-Smith M, McNair R, Bellhouse C, Fairley C, Chen M, Bradshaw C. Women's Views and Experiences of the Triggers for Onset of Bacterial Vaginosis and Exacerbating Factors Associated with Recurrence. PLoS One 2016; 11:e0150272. [PMID: 26930414 PMCID: PMC4773144 DOI: 10.1371/journal.pone.0150272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/11/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Bacterial vaginosis (BV) is the most common vaginal infection affecting women of childbearing age. While the aetiology and transmissibility of BV remain unclear, there is strong evidence to suggest an association between BV and sexual activity. This study explored women's views and experiences of the triggers for BV onset and factors associated with recurrence. METHODS A descriptive, social constructionist approach was chosen as the framework for the study. Thirty five women of varying sexual orientation who had experienced recurrent BV in the past five years took part in semi-structured interviews. RESULTS The majority of women predominantly reported sexual contact triggered the onset of BV and sexual and non-sexual factors precipitated recurrence. Recurrence was most commonly referred to in terms of a 'flare-up' of symptoms. The majority of women did not think BV was a sexually transmitted infection however many reported being informed this by their clinician. Single women who attributed BV onset to sex with casual partners were most likely to display self-blame tendencies and to consider changing their future sexual behaviour. Women who have sex with women (WSW) were more inclined to believe their partner was responsible for the transmission of or reinfection with BV and seek partner treatment or change their sexual practices. CONCLUSION Findings from this study strongly suggest women believe that BV onset is associated with sexual activity, concurring with epidemiological data which increasingly suggest BV may be sexually transmitted. Exacerbating factors associated with recurrence were largely heterogeneous and may reflect the fact it is difficult to determine whether recurrence is due to persistent BV or a new infection in women. There was however evidence to suggest possible transmission and reinfection among WSW, reinforcing the need for new approaches to treatment and management strategies including male and female partner treatment trials.
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Affiliation(s)
- Jade Bilardi
- Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Sandra Walker
- Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Julie Mooney-Somers
- Centre for Values, Ethics and the Law in Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ruth McNair
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Clare Bellhouse
- Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Christopher Fairley
- Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Marcus Chen
- Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Catriona Bradshaw
- Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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46
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Abstract
OBJECTIVE Metronidazole vaginal gel (MVG) 0.75% is a US Food and Drug Administration-approved, 5-day treatment for bacterial vaginosis (BV). This study tested the hypothesis that a shorter treatment course at a higher dose (MVG 1.3%) would yield similar efficacy to 5 days of MVG 0.75%. MATERIALS AND METHODS This phase 2, multicenter, randomized, controlled, investigator-blinded, dose-ranging study enrolled women with a clinical diagnosis of BV. Patients were assigned to MVG 1.3% once daily for 1, 3, or 5 days or MVG 0.75% once daily for 5 days. The therapeutic cure rate, requiring clinical and bacteriological cure, at the end-of-study visit was determined for the per-protocol population. A Kaplan-Meier analysis was used to estimate median time-to-symptom resolution. RESULTS In total, 255 women (mean age = 35 y) were enrolled. The per-protocol population included 189 patients. The therapeutic cure rate was higher in the 1-day (13/43, 30.2%), 3-day (12/48, 25.0%), and 5-day (16/49, 32.7%) MVG 1.3% groups versus the MVG 0.75% group (10/49, 20.4%). Median time-to-resolution of fishy odor was shorter in the 3 MVG 1.3% groups versus the MVG 0.75% group. The 5-day MVG 1.3% group had the lowest rate of symptom return. No clinically important differences were observed in adverse events across treatment groups; most events were mild or moderate in intensity and considered unrelated to treatment. Similar results were found in the modified intent-to-treat population. CONCLUSIONS Metronidazole vaginal gel 1.3% applied once daily for 1, 3, or 5 days showed similar efficacy, safety, and tolerability as MVG 0.75% once daily for 5 days.
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47
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Cox C, Watt AP, McKenna JP, Coyle PV. Mycoplasma hominis and Gardnerella vaginalis display a significant synergistic relationship in bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2016; 35:481-7. [PMID: 26796553 DOI: 10.1007/s10096-015-2564-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 12/21/2015] [Indexed: 11/24/2022]
Abstract
Gardnerella vaginalis plays an important role in bacterial vaginosis (BV,) while the role of genital Mollicutes is less obvious. The diagnosis of BV by use of the current Gram stain Nugent score is also suboptimal for defining the role of Mollicutes that lack a cell wall. Since bacterial load and diversity is an important prerequisite for BV, real-time quantitative polymerase chain reaction (qPCR) assays enable these to be assessed. The purpose of this study was to define the role of genital Mollicutes and potential patterns of synergy with G. vaginalis in women with BV. Vaginal swabs from 130 women categorised by Nugent score as BV (n = 28), intermediate (n = 22) and non-BV (n = 80) were tested against four qPCR TaqMan assays targeting G. vaginalis, Mycoplasma hominis, M. genitalium, Ureaplasma urealyticum and U. parvum. Statistical analyses were used to compare bacterial prevalence and load between the three groups of women. Mycoplasma hominis and G. vaginalis co-infection was significantly more common in BV (60.7 %) compared to intermediate (36.4 %) and non-BV (8.8 %) Nugent scores (p < 0.001). Significantly higher loads of M. hominis (p = 0.001) and G. vaginalis (p < 0.001) were detected in women with BV and the respective loads in M. hominis and G. vaginalis co-infections displayed a significant positive correlation (p < 0.001; r = 0.60). No significant associations were seen with the other Mollicutes. The findings strengthen the evidence of a role for M. hominis in BV and a potential synergy with G. vaginalis. This synergy could be an important trigger of the condition and sexual contact the conduit for the transmission of an otherwise commensal bacterium that could initiate it.
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Affiliation(s)
- C Cox
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK. .,Centre for Infection and Immunity, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - A P Watt
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - J P McKenna
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - P V Coyle
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
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48
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White Hughto JM, Biello KB, Reisner SL, Perez-Brumer A, Heflin KJ, Mimiaga MJ. Health Risk Behaviors in a Representative Sample of Bisexual and Heterosexual Female High School Students in Massachusetts. THE JOURNAL OF SCHOOL HEALTH 2016; 86:61-71. [PMID: 26645422 PMCID: PMC4675046 DOI: 10.1111/josh.12353] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 05/08/2015] [Accepted: 05/10/2015] [Indexed: 05/29/2023]
Abstract
BACKGROUND Differences in sexual health-related outcomes by sexual behavior and identity remain underinvestigated among bisexual female adolescents. METHODS Data from girls (N = 875) who participated in the Massachusetts Youth Risk Behavior Surveillance survey were analyzed. Weighted logistic regression models were fit to examine sexual and psychosocial health by lifetime sexual behavior (behaviorally bisexual vs behaviorally heterosexual) and sexual identity (bisexual vs heterosexual) adjusting for grade and race/ethnicity. RESULTS Overall, 10.5% of girls reported lifetime bisexual behavior and 8.1% reported a bisexual identity. Behavior and identity were discordant for bisexual young women as 53.2% of behaviorally bisexual students had a bisexual identity and 46.8% had a heterosexual identity. Bisexual identity and behavior were associated with unprotected intercourse at last sexual encounter, early sexual debut, 4 or more lifetime partners, history of forced/unwanted sex, sexually transmitted infection testing history, past-year depression, and past-month drug use (all ps < .05). CONCLUSION Bisexuality, whether defined by identity or behavior, is associated with adverse sexual and psychosocial health outcomes in adolescent girls. Studies that explore wellness across the life span, and are designed to recognize developmental differences burgeoning in adolescence, may provide insights into the differential sexual risk outcomes observed among bisexual girls.
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Affiliation(s)
- Jaclyn M White Hughto
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215.
- Department of Chronic Disease Epidemiology, Yale School of Public Health.
| | - Katie B Biello
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215.
- Departments of Behavioral & Social Sciences and Epidemiology, Institute for Community Health Promotion, Brown University School of Public Health.
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215.
- Division of General Pediatrics, Boston Children's Hospital/Harvard Medical School.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health.
| | - Amaya Perez-Brumer
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032.
| | - Katherine J Heflin
- Center for Health Care Strategies, 200 American Metro Blvd., Hamilton, New Jersey 08619.
| | - Matthew J Mimiaga
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215.
- Institute for Community Health Promotion, Brown University School of Public Health.
- Harvard T.H. Chan School of Public Health.
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49
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Zaidi SS, Ocholla AM, Otieno RA, Sandfort TGM. Women Who Have Sex with Women in Kenya and Their Sexual and Reproductive Health. LGBT Health 2015; 3:139-45. [PMID: 26684690 DOI: 10.1089/lgbt.2014.0121] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To describe sexual and reproductive health characteristics of women who have sex with women (WSW) in Kenya's three most populous cities: Kisumu, Mombasa, and Nairobi. Although the last decade has shown an upsurge of health-related research studies in African sexual minority populations, these studies have generally concentrated on the health status of men who have sex with men to the exclusion of WSW. This study presents the first findings on Kenyan WSW's sexual and reproductive health. METHODS A community-based, cross-sectional survey was conducted among 280 women who were at least 18 years old, had at least one female sexual partner in the past three years, and were Kenyan residents. RESULTS A significant proportion of participants reported that they had at least one male sexual partner in the past three years (38.9%), ever had an abortion (13.2%), been infected with at least one sexually transmitted infection (STI) in the past three years (33.9%), and been tested for HIV at least once (88.9%). Of the women who reported having been tested for HIV, 9.4% (7.5% of the total sample) received a positive test result. Some women noted that they were open with their doctors about their sexual orientation, and that their doctors had not reacted negatively to this information. CONCLUSION WSW in Kenya are at risk for negative sexual and reproductive health outcomes, including HIV, STIs, unplanned pregnancy, and unsafe abortion, positioning these women as a critical population for public health efforts. Some WSW actively exercise their agency in making important health decisions. Therefore, this study indicates a need to incorporate WSW's health concerns within Kenyan national health policy programming.
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Affiliation(s)
- Sidra S Zaidi
- 1 Division of Gender, Sexuality and Health, Department of Psychiatry, Columbia University , New York, New York.,2 New York State Psychiatric Institute , New York, New York
| | | | | | - Theo G M Sandfort
- 1 Division of Gender, Sexuality and Health, Department of Psychiatry, Columbia University , New York, New York.,2 New York State Psychiatric Institute , New York, New York
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50
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Muzny CA, Kapil R, Austin EL, Brown L, Hook EW, Geisler WM. Chlamydia trachomatis infection in African American women who exclusively have sex with women. Int J STD AIDS 2015; 27:978-83. [PMID: 26384942 DOI: 10.1177/0956462415604092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/11/2015] [Indexed: 11/15/2022]
Abstract
Little is known about whether Chlamydia trachomatis can be sexually transmitted between women or how often it occurs in women who have sex with women (WSW). We investigated Chlamydia trachomatis prevalence and serum Chlamydia trachomatis-specific antibody responses among African American WSW who reported a lifetime history of sex only with women (exclusive WSW) (n = 21) vs. an age-matched group of women reporting sex with women and men (WSWM) (n = 42). Participants completed a survey, underwent a pelvic examination in which a cervical swab was collected for Chlamydia trachomatis nucleic acid amplification testing (NAAT), and had serum tested for anti-Chlamydia trachomatis IgG1 and IgG3 antibodies using a Chlamydia trachomatis elementary body-based ELISA. No exclusive WSW had a positive Chlamydia trachomatis NAAT vs. 5 (11.9%) WSWM having a positive Chlamydia trachomatis NAAT (p = 0.16). Compared with WSWM, WSW were significantly less likely to be Chlamydia trachomatis seropositive (7 [33.3%] vs. 29 [69%], p = 0.007). Among Chlamydia trachomatis seropositive women, all were seropositive by IgG1, and the magnitude of Chlamydia trachomatis-specific IgG1 responses did not differ in Chlamydia trachomatis-seropositive WSW vs. WSWM. In conclusion, Chlamydia trachomatis seropositivity was relatively common in exclusive African American WSW, though significantly less common than in African American WSWM.
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Affiliation(s)
- Christina A Muzny
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Richa Kapil
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Erika L Austin
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - LaDraka Brown
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edward W Hook
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - William M Geisler
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
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