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

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.