Is the risk for sexually transmissible infections (STI) lower among women with exclusively female sexual partners compared with women with male partners? A retrospective study based on attendees at a Norwegian STI clinic from 2004 to 2014
Sol-Britt Molin A B F , Birgitte Freiesleben De Blasio C D and Anne Olaug Olsen A B EA Department of Rheumatology, Dermatology and Infectious Diseases, The Olafia Clinic p.o.b.4763, Oslo University Hospital, 0506 Oslo, Norway.
B Norwegian National Advisory Unit on Sexually Transmitted Infections, The Olafia Clinic p.o.b.4763, vv0506 Oslo, Norway.
C Oslo Centre for Biostatics and Epidemiology, Department of Biostatics, p.o.b1122 Blindern, Institute of Basic Medical Sciences, University of Oslo, 0317 Oslo, Norway.
D Department of Infectious Disease Epidemiology, Division of Infectious Disease Control, Norwegian Institute of Public Health, p.o.b.4404 Nydalen, 0403 Oslo, Norway.
E Institute of Clinical Medicine, University of Oslo, p.o.b.1171 Blindern, 0318 Oslo, Norway.
F Corresponding author. Email: solmol@ous-hf.no
Sexual Health 13(3) 257-264 https://doi.org/10.1071/SH15193
Submitted: 6 October 2015 Accepted: 4 February 2016 Published: 7 April 2016
Abstract
Background: The prevalence of and the risk for sexually transmissible infections (STIs) for women engaging in same-sex sexual behaviour was investigated among women attending an STI clinic. Methods: Data from electronic medical records were reviewed and logistic regression used to estimate the odds ratio (OR) of STIs. Women reporting life-time exclusively female partners (WSW) and women reporting female and male partners (WSWM) were compared with women reporting exclusively male partners (WSM). Outcomes included: Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoea, HIV and syphilis. Results: The study population comprised 103 564 women (WSW 641, WSWM 12 010 and WSM 90 913). Overall prevalence of STIs was 8%. Crude OR of STIs for WSW: 0.56 (95% CI 0.39–0.81), for WSWM: 0.99 (95% CI 0.92–1.06) compared with WSM. Multivariate analysis revealed an interaction effect between same-sex sexual behaviour and smoking. Among non-smokers; WSW adjusted OR was 0.41 (95% CI 0.21–0.80), WSWM adjusted OR was 0.91 (95% CI 0.81–1.02) compared with WSM. Among smokers; WSW adjusted OR was 1.03 (95% CI 0.63–1.67) for WSWM adjusted OR was 1.00 (CI 95% 0.93–1.13), compared with WSM. Conclusion: This study, including the largest cohort of women reporting life-time exclusively female partners in an STI study, shows that WSW generally are at lower risk for acquiring STIs than WSM. Smoking WSW, however, had the same risk for acquiring bacterial STIs as WSM and WSWM. Our study suggests that all WSW should receive the same encouragement to test for STIs as WSM.
Additional keywords: public health, risk behaviours, lesbian, women who have sex with women.
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