WP 63 Serological Evidence of Infection with Chlamydia Trachomatis, Herpes Simplex Virus Type 2, Syphilis, and HIV Among Women Who Have Sex with Women

Tuesday, June 10, 2014
International Ballroom
Christina A. Muzny, MD, Richa Kapil, PhD, Erika L. Austin, PhD, Edward W. Hook III, MD and William M. Geisler, MD, MPH, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL

Background: There is controversy regarding the risk for acquisition of STIs among women who have sex exclusively with other women (WSW). In an ongoing study of African American WSW, we compared women who reported no lifetime sexual history with men (exclusive WSW) to women reporting sex with both women and men (WSWM) for serological evidence of Chlamydia trachomatis(CT), herpes simplex virus (HSV) type 2, syphilis, and HIV.

Methods: Serum was collected from exclusive WSW and WSWM attending the Jefferson County Department of Health STD clinic in Birmingham, AL. CT, HSV-2, syphilis, and HIV seropositivity were measured using a CT elementary body–based enzyme-linked immunosorbent assay (ELISA), the HerpeSelect®HSV-2 ELISA, the ZeusIFA fluorescent treponemal antibody-adsorption (FTA-ABS) test, and an HIV ELISA.

Results: 20 exclusive WSW were identified and age-matched to 20 WSWM. The mean age of all participants was 23.4. Considering all STIs tested (i.e. CT, HSV-2, syphilis, and HIV), WSWM had significantly higher STI rates than exclusive WSW (15/20 [75%] vs. 6/20 [30%]; p=.004), however no participant was seropositive for syphilis or HIV. Exclusive WSW were significantly less likely to be CT seropositive than WSWM (6/20 [30%] vs. 13/20 [65%]; p=0.03). Among women who were seropositive for CT, exclusive WSW had an older mean age at sexual debut compared to WSWM (17.8 vs. 14.4; p=<0.01). None of the exclusive WSW were HSV-2 seropositive while 9/20 [45%] of the WSWM were HSV-2 seropositive (p=<0.001). The mean age at sexual debut for WSWM with HSV-2 was 13.4.

Conclusions: Serological evidence of CT and HSV-2 infection was significantly less common in exclusive WSW compared to WSWM. Nevertheless, this study provides evidence that CT is transmitted between women. There was no evidence of infection with syphilis or HIV. Additional data is needed to further evaluate behavioral differences between these groups of women.