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Background: Few studies have analyzed STI risks among sexual minority women.
Objectives: We examined sexual behaviors and STIs among sexual minority women accessing STI testing services at Howard Brown Health Center and the Broadway Youth Center.
Methods: Data were collected from electronic medical record abstraction and as part of the STD Surveillance Network (SSuN). Chi-square tests were used to compare positivity by patient characteristics.
Results: January 2009-June 2011, 2,347 women were screened for urogenital chlamydia (CT) and gonorrhea (GC) at 2,991 visits. Women were median age 23, 47% White, 22% Black, 15% Hispanic, 7% Asian/PI, and 9% other race/ethnicity. Positivity was 7.4% (220/2,991) for CT and 1.5% (45/2,991) for GC. CT positivity was higher among heterosexual (8.3%; 158/1,914) and bisexual women (6.9%; 29/418) than among lesbian women (2.7%; 9/331); p<0.01. GC positivity was 1.7% (32/1,914) among heterosexual women, 0.7% (3/418) among bisexual women, and 1.2% (4/331) among lesbian women, and did not differ significantly according to sexual orientation. Among 494 women who provided data on sexual behavior in the past 90 days, 18% of lesbian, 63% of bisexual, and 99% of heterosexual women reported sex exclusively with men; 64%; 7%; and 0.3% of lesbian, bisexual, and heterosexual women reported sex exclusively with women; and 18%; 31% and 1% of lesbian, bisexual, and heterosexual women reported sex with both men and women. In this subset, all 24 cases of CT and 8 cases of GC were among women who reported sex exclusively with men, regardless of sexual orientation.
Conclusions: Sexual behavior may be a better predictor of STI risk than sexual identity among sexual minority women.
Implications for Programs, Policy, and Research: Providers should assess sexual behaviors, including gender of sex partners, when screening for CT and GC among sexual minority women.