Background: Young women who have sex with women and men (WSWM) are an understudied population with respect to sexual behavior and sexually transmitted infections (STI). Understanding these sexual behaviors and STI risks can improve public health interventions and STI management.

Methods: 109 sexually active young women, age 15-24, were recruited from adolescent and Ob/Gyn clinics in Baltimore, Maryland. Participants completed a questionnaire using an Audio Computer-Assisted Self-Interview and were tested for bacterial vaginosis (BV), chlamydia, gonorrhea, HIV, and trichomonas infection. Fisher’s exact and Mann-Whitney U tests were performed.

Results: Of the 109, 12 (11%) reported having vaginal sex with both women and men in the past 3 months. WSWM were mean age 19.8±2.9 years, majority black (58%), and 5.0±5.4 years younger than their oldest partner. WSWM were more likely to report having two or more current partners (42% vs. 6%, p<0.001), a new vaginal sex partner within the month (50% vs. 29%, p=0.03), partners who are non-monogamous (58% vs. 18%, p=0.004), and having a “one-night stand” (50% vs. 15%, p=0.01) compared to women who have sex with men exclusively (WSM). Though not statistically significant, WSWM reported increased anal sex (25% vs. 18%, p=0.46) and using marijuana and having sex while high or drunk compared to WSM. BV (56% vs. 36%, p=0.30) and STIs (17% vs. 13%, p=0.65) were not significantly higher for WSWM compared to WSM. 

Conclusions: While WSWM had a similar prevalence of BV and STIs, they were more likely to engage in high-risk sexual behaviors compared to their peers who report only having sex with men. It is important for providers to take into account these risk factors for WSWM in STI screening and counseling.

06 / SEXUAL BEHAVIORS AND STI RISK AMONG YOUNG WOMEN WHO HAVE SEX WITH WOMEN AND MEN IN BALTIMORE, MARYLAND