Sexually transmitted disease (STD) diagnoses and mental health disparities among women who have sex with women screened at an urban community health center, Boston, MA, 2007.
Sexually transmitted disease (STD) diagnoses and mental health disparities among women who have sex with women screened at an urban community health center, Boston, MA, 2007.
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DOI：
10.1097/olq.0b013e3181b41314
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发表时间：
2010-01
影响因子：
3.1
通讯作者：
Mayer KH
中科院分区：
文献类型：
--
作者：
Reisner SL;Mimiaga MJ;Case P;Grasso C;O'Brien CT;Harigopal P;Skeer M;Mayer KH
越来越多的研究记录了与女性发生性关系的女性（WSW）与仅与男性发生性关系的女性（WSM）之间的心理健康差异。然而，仍然缺乏研究探索这些指标以及性传播疾病（STD）和WSW性健康。对2007年7月至2007年12月期间在马萨诸塞州波士顿市的一家城市社区卫生中心接受性病筛查的所有女性患者（n=368）进行了回顾性病历审查。去识别电子病历数据（例如，人口统计学、心理社会学、性健康）进行了分析，并与STD阳性相关联。没有性行为记录在病历中的女性（n=58）被排除在本分析之外。双变量和多变量逻辑回归程序检查性和心理健康指标，包括性取向。27%的参与者是WSW（17%仅WSW和10% WSW/M）。总的来说，5%的WSW被诊断患有新的STD（HPV，肛门生殖器疣，生殖器疱疹，PID），17%有既往STD病史。在调整人口统计学的多变量模型中，WSW不成比例地更有可能在他们的医疗记录中发现心理健康和心理社会问题，包括：抑郁症，焦虑症和创伤后应激障碍的临床诊断，自杀企图史和住院精神病/心理健康治疗。然而，WSW比WSM更不可能从事“高危”HIV/STD性行为。在最终的多变量模型中，与异性行为相比，同性行为与被诊断患有STD的不同可能性无关。然而，与没有性病的WSW相比，被诊断患有性病的WSW患双相情感障碍和利用门诊心理健康咨询服务的几率增加。与没有性病史的WSW相比，有性病史的WSW过去企图自杀的几率增加，利用门诊和住院精神健康治疗服务，并有注射毒品使用史。患有性病的WSW可能有严重的心理社会问题。进一步的研究是必要的，以更好地了解性行为和健康之间的关系，以及指导干预措施的发展，以改善WSW之间的健康差距，特别是在心理社会领域。
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.