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Background: A growing body of research documents mental health disparities among women who have sex with women (WSW) compared to women who have sex with men only (WSM). However, little research has explored these indicators alongside sexually transmitted diseases (STDs).
Objectives: The purpose of this study was to: (1) explore STD prevalence by sexual behavior; (2) describe differences between WSW and WSM; (3) examine mental health disparities and STDs.
Methods: A retrospective chart review was conducted of female patients (n=368) screened for STDs between July-December 2007 at an urban community health center in Boston, Massachusetts. Bivariate and multivariable logistic regression procedures examined sexual and psychosocial health indicators, including sexual preference. Women who did not have sexual behavior documented in their medical chart (n=58) were excluded.
Results: 27% were WSW; 5% of WSW were diagnosed with a new STD and 17% had a STD history. WSW were more likely to have mental health diagnoses. In a final multivariable model, same sex behavior was not associated with a different likelihood of being diagnosed with an STD, compared to opposite sex behavior. WSW diagnosed with a new STD were at increased odds of bipolar disorder and utilizing outpatient mental health counseling services compared to WSW not diagnosed with a new STD. WSW with a STD history were at increased odds of attempted suicide, utilizing outpatient and inpatient mental health treatment services, and injection drug use compared to WSW with no STD history.
Conclusions: WSW with STDs may be disproportionately affected by psychosocial problems. Further research is warranted to better understand the relationship between sexual behavior and mental health, as well as to guide interventions to ameliorate health disparities among WSW.
Implications for Programs, Policy, and/or Research: All sexually active women, regardless of sexual orientation and behavior, should be routinely screened for STDs. Future research might benefit from examining “intertwined syndemics” of sexual and psychosocial risk.