Intimately Transmitted Infections Among Ladies Who Have Intercourse With Ladies

Intimately Transmitted Infections Among Ladies Who Have Intercourse With Ladies

Linda M. Gorgos, Jeanne M. Marrazzo, intimately sent Infections Among ladies Who Have Sex With Women, Clinical Infectious conditions, Volume 53, problem suppl_3, 15 2011, Pages S84–S91, https: // december


Women that have sexual intercourse with ladies (WSW) are a definite group that is diverse variants in intimate identification, intimate habits, intimate techniques, and danger habits. WSW have reached danger of acquiring microbial, viral, and protozoal intimately sent infections (STIs) from present and previous lovers, both male and female. Bacterial vaginosis is frequent among ladies in basic and many more therefore among ladies with feminine lovers. WSW really should not be assumed become at low or no danger for STIs centered on intimate orientation, and reporting of same-sex behavior by ladies must not deter providers from considering and screening that is performing STIs, including chlamydia, inside their customers relating to present instructions. Effective distribution of intimate wellness solutions to WSW requires a thorough and discussion that is open of and behavioral dangers, beyond intimate identification, between care providers and their feminine consumers.

On the basis of the 2002 nationwide Survey of Family development (NSFG), a nationally representative test of households in the usa, 4.4% of females aged 15–44 years reported having a sex that is female in past times year and 1.3% reported having solely feminine intercourse lovers in past times year. Utilizing measures of both self-reported intimate identification and sexual behavior, it had been approximated that 1.3percent–1.9% of US women can be lesbians and that 3.1%–4.8% are bisexual 1. Lifetime behavior that is same-sex commonly reported by ladies in large population-based studies, which range from 11.2per cent of females within the 2002 NSFG to 7.1% of females in nationwide health insurance and Nutrition Examination Survey (NHANES), 2001–2006 1, 2.

Although considerable information can be found regarding intimately transmitted infections (STIs) among males that have intercourse with males, reasonably little was posted about STI prevalence and dangers among other sexual and gender minorities, including women that have intercourse with ladies (WSW). Medical care providers and their feminine customers would take advantage of increased understanding of STI risks and testing guidance for women that have actually same-sex lovers.


When preparing when it comes to 2010 upgrade towards the Centers for Disease Control and Prevention’s intimately sent Diseases (STD) Treatment instructions, a systematic search for the literature on sexually transmitted infections in WSW ended up being carried out utilizing PubMed (National Library of Medicine) in October 2008 with subsequent updates through December 2010. MeSH (healthcare topic Heading) terms and key words utilized included “lesbian, ” “women who possess intercourse with females, ” “homosexuality, female, ” “sexually transmitted disease, ” “gonorrhea, ” “chlamydia, ” “syphilis, ” “herpes simplex virus, ” “human papillomavirus, ” and “human immunodeficiency virus. ” Abstracts from major STD–related conferences at that time period 2005–2009 had been additionally searched utilizing the search that is same and had been considered for addition. Writers of abstracts had been contacted to learn more if required. Key concerns had been developed predicated on breakdown of these sources as well as in assessment with specialists in the industries of infectious gender and disease minority wellness.

What exactly is Understood In Regards To The Epidemiology that is current of Among WSW?

Chlamydia trachomatis and Neisseria gonorrhoeae infections among WSW have already been considered unusual. Previous studies that included females from STD clinics and health that is sexual reported a prevalence of chlamydial illness among WSW which range from 0.6per cent to 3.0per cent and of gonorrhea from 0.3per cent to 2.8per cent 3–6. Nevertheless, no information on C. Trachomatis or N. Gonorrhoeae infections in WSW from community-based or venues that are population-based available. In 2008, Singh et that is al examined chlamydia positivity among WSW aged 15–24 years tested at family preparation clinics taking part in the Infertility Prevention Project within the northwestern united states of america from 1997 to 2005. WSW and ladies who have sexual intercourse with men and women (WSMW) into the year just before assessment had been included. Chlamydia positivity ended up being 7.1% among both WSW and WSMW and stayed stable within the amount of observation when you look at the research. Chlamydia positivity through the time that is same for females reporting just male lovers into the one year ahead of screening had been 5.3%. Dangers for chlamydial disease among WSW and WSMW were age 8, syphilis 9, and hepatitis A 10. Even though it is presumably uncommon, intimate transmission of peoples immunodeficiency virus (HIV) could also take place in this manner 11. Prior information suggesting possible HIV transmission between feminine lovers is dependant on instance reports where assumed transmission that is female-to-female according to deficiencies in other identified danger factors 12–14. A study of 960 000 blood that is female neglected to determine any HIV-infected women that identified same-sex contact because their single risk element 15. Comparable outcomes had been present in a much smaller survey of lesbian and bisexual ladies 1
. A 2003 instance report is exclusive in pinpointing a lady with no other reported behavioral danger for HIV purchase except that intimate connection with her sole feminine partner; she had been found become recently contaminated with an equivalent HIV genotype to her understood HIV-infected feminine partner 11. More widespread may be the possibility of WSW to obtain HIV through other modes, including injection medication usage and intimate connection with high-risk male lovers 17–19.

Viral STIs including herpes virus kind 1 and 2 (HSV-1 and HSV-2) and peoples papillomavirus (HPV) take place in WSW. Information through the 2002 NSFG had been utilized to look at self-reported viral STIs among females aged 15–44 years. A brief history of vaginal herpes or warts that are genital reported with greater regularity by bisexual females (15.0percent–17.2%) than by lesbians (2.3%–6.7%) and their heterosexual counterparts (8.7%–10.0%) 20.

A seroprevalence research of HSV in 392 WSW discovered that 46% had antibodies to HSV-1 and 8% had antibodies to HSV-2. Increasing age had been predictive of higher seroprevalence of both HSV-1 and 2, and HSV-2 seropositivity ended up being related to having a male partner with vaginal herpes. Associated with the 78 ladies in the study reporting never ever having had a male partner, 3% had been HSV-2 seropositive. HSV-1 seroprevalence increased with greater amounts of feminine lovers 21. In a different research of HSV-1 prevalence and purchase among ladies, receptive sex that is oral connected with HSV-1 purchase 22. More modern data from NHANES carried out in 2001–2006 among females aged 18–59 years demonstrated an HSV-2 seroprevalence of 30.3% among ladies reporting same-sex lovers into the previous year, 36.2% among females reporting same-sex lovers in their life time, and 23.8% among females reporting no life time same-sex behavior 2. HSV-2 seroprevalence among ladies self-identifying as homosexual or lesbian was 8.2%, just like a past clinic-based research of WSW 2, 21. In addition, in a longitudinal research of HSV-2 purchase among females, the existence of microbial vaginosis (BV) ended up being related to an elevated danger of acquiring HSV-2 (hazard ratio HR, 2.1 95% CI, 1.0–4.5; P =. 05). The population that is calculated danger of BV for HSV-2 seroconversion had been 21% 23. Analyses of information from NHANES, 2001–2004, also discovered a connection involving the existence of BV as well as the seroprevalence of HSV-1 and HSV-2 in females aged 20–44 years 24. There are not any posted studies up to now to show in the event that remedy for BV could reduce acquisition of HSV-2 in women.

Genital HPV illness is typical, with specific HPV kinds associated with cervical cancer tumors. WSW had been when assumed become at low danger for HPV purchase and cervical cancer tumors. Information now strongly help that HPV infections are typical among WSW and therefore sexual transmission of HPV likely does occur between ladies 25–27. Prior situation reports highlighted the existence of cervical neoplasia and HPV among women that had no past reputation for intercourse with men 28, 29. HPV in WSW is examined making use of both HPV serology and DNA detection techniques. In a 1995 study, among WSW whom reported never ever having possessed a male partner that is sexual 26% had antibodies to HPV-16 and 42percent had antibodies to HPV-6. No difference between the prevalence of HPV-16 and HPV-6 antibodies had been discovered between females with and females with no past reputation for male lovers (P =. 16). HPV DNA ended up being detected in vaginal tract specimens in 30% associated with the females enrolled. The existence of HPV DNA had been related to present cigarette smoking (chances ratio OR, 3.4 95% CI, 1.2–9.6) and a faster time since final intercourse with a male partner (P =. 002). The prevalence of squamous intraepithelial lesions on Pap smear ended up being 4%, just like that present in heterosexual ladies 25. A subsequent bigger research once again revealed the prevalence that is high of in WSW, with 13% having HPV DNA in vaginal tract specimens (74% of that have been oncogenic kinds) and 4.4% having either low-grade or high-grade squamous intraepithelial lesions 26.

Intimately Transmitted Infections Among Ladies Who Have Intercourse With Ladies

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