Keely S Paris, Christine M Khosropour, Jennifer E Balkus, Mary Bridget Waters, Kristen M Kreisel, Lisa E Manhart
{"title":"Comparison of Chlamydia trachomatis Seroprevalence and Risk Factors for Infection Among Women by Gender/Sex of Sex Partner, United States, 2013-2016.","authors":"Keely S Paris, Christine M Khosropour, Jennifer E Balkus, Mary Bridget Waters, Kristen M Kreisel, Lisa E Manhart","doi":"10.1097/OLQ.0000000000002134","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Women who report sex with women are thought to have lower risk for Chlamydia trachomatis (CT) infection than women who report sex with men only (WSM-only), but comparisons of lifetime burden are limited.</p><p><strong>Methods: </strong>Among 1,418 sexually-experienced women aged 18-39 years participating in the National Health and Nutrition Examination Survey (2013-2016), we estimated weighted CT seroprevalence and Wald-based 95% confidence intervals (CI) in women who reported ever having sex with a woman (all reported having sex with men also) (WSWM) compared to WSM-only. We defined seropositivity as detection of Pgp3 antibodies and used stratified Poisson regression with robust standard errors to estimate prevalence ratios.</p><p><strong>Results: </strong>Over half (58.3%) were White non-Hispanic; 16.2% were WSWM. WSWM were somewhat younger (mean = 27.8 vs. 29.0 years, p = 0.07), younger at sexual debut (mean = 15.6 vs. 17.5 years, p < 0.001), and had more lifetime male sexual partners (mean = 15.9 vs. 6.4, p < 0.001) than WSM-only. Weighted CT seroprevalence was 38.9% (95%CI = 30.4-47.4) in WSWM and 28.6% (95%CI = 24.4-32.9) in WSM-only. Correlates of higher CT seroprevalence in both groups were Black non-Hispanic race/ethnicity, Hispanic ethnicity, and CT infection in the prior year. Having ≥5 lifetime male partners compared to 1-2 partners was associated with higher seroprevalence among WSWM (PR = 4.5; 95%CI = 1.77-11.44) and WSM-only (PR = 2.7; 95%CI = 1.87-3.69). Among WSWM, bisexual identity was associated with lower seroprevalence. Among WSM-only, low income and younger age at sexual debut were associated with higher seroprevalence.</p><p><strong>Conclusion: </strong>Lifetime CT burden was higher in WSWM than WSM-only. Number of lifetime male partners was the strongest predictor of seropositivity for WSWM.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexually transmitted diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/OLQ.0000000000002134","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Women who report sex with women are thought to have lower risk for Chlamydia trachomatis (CT) infection than women who report sex with men only (WSM-only), but comparisons of lifetime burden are limited.
Methods: Among 1,418 sexually-experienced women aged 18-39 years participating in the National Health and Nutrition Examination Survey (2013-2016), we estimated weighted CT seroprevalence and Wald-based 95% confidence intervals (CI) in women who reported ever having sex with a woman (all reported having sex with men also) (WSWM) compared to WSM-only. We defined seropositivity as detection of Pgp3 antibodies and used stratified Poisson regression with robust standard errors to estimate prevalence ratios.
Results: Over half (58.3%) were White non-Hispanic; 16.2% were WSWM. WSWM were somewhat younger (mean = 27.8 vs. 29.0 years, p = 0.07), younger at sexual debut (mean = 15.6 vs. 17.5 years, p < 0.001), and had more lifetime male sexual partners (mean = 15.9 vs. 6.4, p < 0.001) than WSM-only. Weighted CT seroprevalence was 38.9% (95%CI = 30.4-47.4) in WSWM and 28.6% (95%CI = 24.4-32.9) in WSM-only. Correlates of higher CT seroprevalence in both groups were Black non-Hispanic race/ethnicity, Hispanic ethnicity, and CT infection in the prior year. Having ≥5 lifetime male partners compared to 1-2 partners was associated with higher seroprevalence among WSWM (PR = 4.5; 95%CI = 1.77-11.44) and WSM-only (PR = 2.7; 95%CI = 1.87-3.69). Among WSWM, bisexual identity was associated with lower seroprevalence. Among WSM-only, low income and younger age at sexual debut were associated with higher seroprevalence.
Conclusion: Lifetime CT burden was higher in WSWM than WSM-only. Number of lifetime male partners was the strongest predictor of seropositivity for WSWM.
期刊介绍:
Sexually Transmitted Diseases, the official journal of the American Sexually Transmitted Diseases Association, publishes peer-reviewed, original articles on clinical, laboratory, immunologic, epidemiologic, behavioral, public health, and historical topics pertaining to sexually transmitted diseases and related fields. Reports from the CDC and NIH provide up-to-the-minute information. A highly respected editorial board is composed of prominent scientists who are leaders in this rapidly changing field. Included in each issue are studies and developments from around the world.