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Women Who Have Sex With Women in The United States: Prevalence, Sexual Behavior and Prevalence of Herpes Simplex Virus Type 2 Infection—Results From National Health and Nutrition Examination Survey 2001–2006

Xu, Fujie MD, PHD; Sternberg, Maya R. PHD; Markowitz, Lauri E. MD

Sexually Transmitted Diseases: July 2010 - Volume 37 - Issue 7 - p 407-413
doi: 10.1097/OLQ.0b013e3181db2e18
Original Study

Objectives: To estimate the prevalence of same-sex sexual behavior in women in the United States; to describe demographic and behavioral characteristics and the prevalence of herpes simplex virus type 2 (HSV-2) infection.

Methods: As part of the National Health and Nutrition Examination Surveys during 2001–2006, women aged 18 to 59 years were interviewed about sexual behaviors using audio computer assisted self-interview. Persons aged 14 to 49 years were tested for antibodies to HSV-2.

Results: Among sexually experienced women aged 18 to 59 years, 7.1% (95% confidence interval, 6.1–8.2) reported ever having had sex with a woman (WSW-ever) and 2.7% in the past year. The prevalence of WSW-ever correlated negatively with age, highest (9.4%) in 18 to 29-year-olds and lowest (5.5%) in 50 to 59-year-olds. Among WSW-ever, 52.6% self-identified as heterosexual/straight, 28.3% as bisexual, and 19.1% as homosexual/lesbian. Among WSW-ever, demographic characteristics were similar but sexual behaviors were different by sexual orientation: 31.3% of heterosexuals, 38.9% of bisexuals, and 12.9% of homosexuals reported first sex at age 14 or younger (P = 0.005); the median number of lifetime male partners was 10.8, 17.6, and 2.9, respectively (P < 0.0001). Among WSW-ever, the prevalence of HSV-2 was 45.6% in heterosexuals, 35.9% in bisexuals, and 8.2% in homosexuals (P = 0.001). In comparison, among women who reported no same-sex partners, the prevalence of HSV-2 was 23.8%.

Conclusions: In this population-based sample of women, self-reported same-sex behaviors were increasingly more prevalent in younger women. Compared with homosexual WSW-ever and women who reported never having sex with other women, heterosexual or bisexual WSW-ever had higher HSV-2 seroprevalence.

A nationally representative survey found that same-sex behavior (women who have sex with women) was increasing in younger women, and that among WSW, HSV-2 seroprevalence was higher in those who reported their sexual orientation as heterosexual or bisexual.

Centers for Disease Control and Prevention, Atlanta, GA

Correspondence: Fujie Xu, MD, PhD, Mailstop E-02, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333. E-mail: FAX1@CDC.GOV.

Received for publication September 11, 2009, and accepted December 1, 2009.

© Copyright 2010 American Sexually Transmitted Diseases Association