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, there remains a dearth of research exploring these indicators alongside sexually transmitted diseases (STDs) and WSW sexual health.
A retrospective chart review was conducted of all female patients (n=368) screened for STDs between July 2007 and December 2007 at an urban community health center in Boston, MA. De-identified electronic medical record data (e.g., demographics, psychosocial, sexual health) were analyzed and linked to STD positivity. Women who did not have sexual behavior documented in their medical chart (n=58) were excluded from this analysis. Bivariate and multivariable logistic regression procedures examined sexual and psychosocial health indicators, including sexual preference.
Twenty-seven percent of participants were WSW (17% WSW only and 10% WSW/M). Overall, 5% of WSW were diagnosed with a new STD (HPV, anogenital warts, genital herpes, PID) and 17% had a history of a prior STD. In multivariable models adjusting for demographics, WSW were disproportionately more likely to have mental health and psychosocial issues noted in their medical records, including: a clinical diagnosis of depression, anxiety, and PTSD, history of suicide attempts, and inpatient psychiatric/mental health treatment. However, WSW were significantly less likely than WSM to engage in “high risk” HIV/STD sexual behavior. 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. However, WSW diagnosed with STDs were at increased odds of having bipolar disorder and utilizing outpatient mental health counseling services compared to WSW without STDs. WSW with a history of STDs were at increased odds of having attempted suicide in the past, utilizing both outpatient and inpatient mental health treatment services, and having a history of injection drug use compared to WSW without a history of STDs.
WSW with STDs may have serious psychosocial problems. Further research is warranted to better understand the relationship between sexual behavior and health, as well as to guide the development of interventions to ameliorate health disparities among WSW, particularly in the psychosocial domain.