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Sexual Behaviors, Perception of Sexually Transmitted Infection Risk, and Practice of Safe Sex Among Southern African American Women Who Have Sex With Women

Muzny, Christina A. MD*; Harbison, Hanne S. MHS, MSN, CRNP*; Pembleton, Elizabeth S. MPH; Austin, Erika L. PhD*

Sexually Transmitted Diseases: May 2013 - Volume 40 - Issue 5 - p 395–400
doi: 10.1097/OLQ.0b013e31828caf34
Original Study

Background Women who have sex with women (WSW) and women who have sex with women and men (WSWM) are frequently perceived to be at low risk for sexually transmitted infections (STIs), although data show that their STI rates are similar to heterosexual women. Little research has examined sexual behaviors, perceptions of STI risk, and practice of safe sex among African American WSW/WSWM living in the Southern United States, a population of women likely to be at high risk for STIs.

Methods Focus group discussions were conducted with African American WSW/WSWM living in Birmingham, Alabama, to explore their sexual behaviors with women, perceptions of STI risk from female (and male) sexual partners, and practice of safe sex. Digital audio-recordings were transcribed and analyzed using HyperRESEARCH software.

Results Seven focus groups were conducted between August 2011 and March 2012, with 29 total participants. Women reported a broad range of sexual behaviors with female partners. They were more aware of their risk for STI acquisition from male partners than from female partners and felt that their best options for safe sex in their relationships with women were practicing good hygiene and requiring proof of STI testing results.

Conclusions African American WSW/WSWM in this study were aware of their STI risk, more so with regard to men, and desired accurate information on safer sex options in their sexual relationships with women. Health care providers can assist these women by helping them apply their existing knowledge of heterosexual STI transmission to their female sexual partnerships.

African American women who have sex with women and those who have sex with women and men in Birmingham, Alabama, were more aware of their risk for sexually transmitted infection acquisition from male partners and felt that options for safe sex in female partnerships were limited.

From the *Division of Infectious Diseases and †Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL

This study was funded by a Developmental Award granted to Christina Muzny by the American Sexually Transmitted Diseases Association. The authors thank Edward Hook, III, for helpful discussions on manuscript preparation, Marga Jones for her assistance with data management during this study, Allison Whittington, Rhonda Whidden, Saralyn Richter, and Christen Press for referring eligible participants at the Jefferson County Health Department Sexually Transmitted Disease Clinic for participation in this study, and Jim Raper for allowing the use of the conference room at the University of Alabama at Birmingham HIV Clinic to conduct the focus group discussions.

Correspondence: Christina Muzny, MD, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL. E-mail:

Received for publication August 21, 2012, and accepted February 11, 2013.

© Copyright 2013 American Sexually Transmitted Diseases Association