Sexual Discordance and Sexual Partnering Among Heterosexual Women

Abstract

This study examined characteristics of self-identified heterosexual women who were concordant or discordant in their sexual behavior and the association of discordance and sexual partnering among those aged 15–44 years from the 2006–2010 National Survey of Family Growth (n = 7,353). Sexual concordance was defined as reporting a heterosexual identity and no female partners in the past year; discordance was reporting a heterosexual identity and having at least one female partner in the past year. Sexual partnering was defined as being concurrent, serially monogamous or monogamous with a male partner in the previous year. Polytomous logistic regression models evaluated the association between sexual discordance and sexual partnering. Among self-identified heterosexual, sexually active women, 11.2 % reported ever having had a same sex partner. Heterosexually discordant women who had both male and female partners in the previous year were 5.5 times as likely to report having a concurrent relationship (95 % CI 2.77–11.09) and 2.4 times as likely to report engaging in serially monogamous relationships (95 % CI 1.19–4.97) with male partners. Discordance between heterosexual identity and same sex behavior is a factor in risky behaviors. Women who have sex with women and men may act as bridges for the transmission of STDs, particularly to their female partners. Sexual education should include information inclusive of non-heteronormative behaviors and identities to provide sexual minorities with the tools and information they need. Clinical guidelines should ensure that all women are offered counseling and screening for reproductive and sexual health.

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References

  1. Adimora, A. A., Schoenbach, V. J., Martinson, F., Donaldson, K. H., Stancil, T. R., & Fullilove, R. E. (2004). Concurrent sexual partnerships among African Americans in the rural South. Annals of Epidemiology, 14, 155–160. doi:10.1016/S1047-2797(03)00129-7.

    Article  PubMed  Google Scholar 

  2. Adimora, A. A., Schoenbach, V. J., Taylor, E. M., Khan, M. R., & Schwartz, R. J. (2011). Concurrent partnerships, nonmonogamous partners, and substance use among women in the United States. American Journal of Public Health, 101, 128–136. doi:10.2105/AJPH.2009.174292.

    PubMed Central  Article  PubMed  Google Scholar 

  3. Ayala, J., & Coleman, H. (2000). Predictors of depression among lesbian women. Journal of Lesbian Studies, 4, 71–86. doi:10.1300/J155v04n03_04.

    Article  Google Scholar 

  4. Baumeister, R. F. (2000). Gender differences in erotic plasticity: The female sex drive as socially flexible and responsive. Psychological Bulletin, 126, 347–374.

    Article  PubMed  Google Scholar 

  5. Bersamin, M. M., Fisher, D. A., Walker, S., Hill, D. L., & Grube, J. W. (2007). Defining virginity and abstinence: Adolescents’ interpretations of sexual behaviors. Journal of Adolescent Health, 41, 182–188. doi:10.1016/j.jadohealth.2007.03.011.

    PubMed Central  Article  PubMed  Google Scholar 

  6. Bevier, P. J., Chiasson, M. A., Heffernan, R. T., & Castro, K. G. (1995). Women at a sexually transmitted disease clinic who reported same-sex contact: Their HIV seroprevalence and risk behaviors. American Journal of Public Health, 85, 1366–1371.

    PubMed Central  Article  PubMed  Google Scholar 

  7. Bogart, L. M., Cecil, H., Wagstaff, D. A., Pinkerton, S. D., & Abramson, P. R. (2000). Is it “sex”?: College students’ interpretations of sexual behavior terminology. Journal of Sex Research, 37, 108–116. doi:10.1080/00224490009552027.

    Article  Google Scholar 

  8. Bostwick, W. B., Hughes, T. L., & Johnson, T. (2005). The co-occurrence of depression and alcohol dependence symptoms in a community sample of lesbians. Journal of Lesbian Studies, 9, 7–18. doi:10.1300/J155v09n03_02.

    Article  PubMed  Google Scholar 

  9. Burgard, S. A., Cochran, S. D., & Mays, V. M. (2005). Alcohol and tobacco use patterns among heterosexually and homosexually experienced California women. Drug and Alcohol Dependence, 77, 61–70. doi:10.1016/j.drugalcdep.2004.07.007.

    PubMed Central  Article  PubMed  Google Scholar 

  10. Case, P., Austin, S. B., Hunter, D. J., Manson, J. E., Malspeis, S., Willett, W. C., & Spiegelman, D. (2004). Sexual orientation, health risk factors, and physical functioning in the Nurses’ Health Study II. Journal of Women’s Health, 13, 1033–1047.

    Article  PubMed  Google Scholar 

  11. Chae, D. H., & Ayala, G. (2010). Sexual orientation and sexual behavior among Latino and Asian Americans: Implications for unfair treatment and psychological distress. Journal of Sex Research, 47, 451–459. doi:10.1080/00224490903100579.

    Article  PubMed  Google Scholar 

  12. Chandra, A., Martinez, G. M., Mosher, W. D., Abma, J. C., & Jones, J. (2005). Fertility, family planning, and reproductive health of U.S. women: Data from the 2002 National Survey of Family Growth. Vital and Health Statistics (Series 23). Data from the National Survey of Family Growth, 25, 1–160.

    Google Scholar 

  13. Chandra, A., Mosher, W. D., Copen, C., & Sionean, C. (2011). Sexual behavior, sexual attraction, and sexual identity in the United States: Data from the 20062008 National Survey of Family Growth (National Health Statistics Report No. 36). Hyattsville, MD: National Center for Health Statistics.

  14. Cochran, S. D., Ackerman, D., Mays, V. M., & Ross, M. W. (2004). Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction, 99, 989–998. doi:10.1111/j.1360-0443.2004.00759.x.

    PubMed Central  Article  PubMed  Google Scholar 

  15. Cochran, S. D., Keenan, C., Schober, C., & Mays, V. M. (2000). Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the U.S. population. Journal of Consulting and Clinical Psychology, 68, 1062–1071. doi:10.1037/0022-006X.68.6.1062.

    PubMed Central  Article  PubMed  Google Scholar 

  16. Conron, K. J., Mimiaga, M. J., & Landers, S. J. (2010). A population-based study of sexual orientation identity and gender differences in adult health. American Journal of Public Health, 100, 1953–1960. doi:10.2105/AJPH.2009.174169.

    PubMed Central  Article  PubMed  Google Scholar 

  17. Diamond, L. M. (2003). What does sexual orientation orient? A biobehavioral model distinguishing romantic love and sexual desire. Psychological Review, 110, 173–192.

    Article  PubMed  Google Scholar 

  18. Diamond, L. M. (2007). The evolution of plasticity in female–female desire. Journal of Psychology & Human Sexuality, 18, 245–274. doi:10.1300/J056v18n04_01.

    Article  Google Scholar 

  19. Drabble, L., Midanik, L. T., & Trocki, K. (2005). Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: Results from the 2000 National Alcohol Survey. Journal of Studies on Alcohol, 66, 111–120.

    Article  PubMed  Google Scholar 

  20. Eaton, L., Kalichman, S., Cain, D., Cherry, C., Pope, H., Fuhrel, A., & Kaufman, M. (2008). Perceived prevalence and risks for human papillomavirus (HPV) infection among women who have sex with women. Journal of Women’s Health, 17, 75–83.

    Article  PubMed  Google Scholar 

  21. Fethers, K., Marks, C., Mindel, A., & Estcourt, C. S. (2000). Sexually transmitted infections and risk behaviours in women who have sex with women. Sexually Transmitted Infections, 76, 345–349.

    PubMed Central  Article  PubMed  Google Scholar 

  22. Foxman, B., Newman, M., Percha, B., Holmes, K. K., & Aral, S. O. (2006). Measures of sexual partnerships: Lengths, gaps, overlaps, and sexually transmitted infection. Sexually Transmitted Diseases, 33, 209–214. doi:10.1097/01.olq.0000191318.95873.8a.

    Article  PubMed  Google Scholar 

  23. Frost, D. M., & Meyer, I. H. (2009). Internalized homophobia and relationship quality among lesbians, gay men, and bisexuals. Journal of Counseling Psychology, 56, 97–109. doi:10.1037/a0012844.

    PubMed Central  Article  PubMed  Google Scholar 

  24. Gates, G. J. (2010). Sexual minorities in the 2008 General Social Survey: Coming out and demographic characteristics. Retrieved February 17, 2014 from http://www.escholarship.org/uc/item/9k77z7d4.

  25. Gilman, S. E., Cochran, S. D., Mays, V. M., Hughes, M., Ostrow, D., & Kessler, R. C. (2001). Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. American Journal of Public Health, 91, 933–939.

    PubMed Central  Article  PubMed  Google Scholar 

  26. Gorgos, L. M., & Marrazzo, J. M. (2011). Sexually transmitted infections among women who have sex with women. Clinical Infectious Diseases, 53(Suppl. 3), S84–S91. doi:10.1093/cid/cir697.

    Article  PubMed  Google Scholar 

  27. Gruskin, E. P., Greenwood, G. L., Matevia, M., Pollack, L. M., & Bye, L. L. (2007). Disparities in smoking between the lesbian, gay, and bisexual population and the general population in California. American Journal of Public Health, 97, 1496–1502. doi:10.2105/AJPH.2006.090258.

    PubMed Central  Article  PubMed  Google Scholar 

  28. Kissinger, P., Rice, J., Farley, T., Trim, S., Jewitt, K., Margavio, V., & Martin, D. H. (1999). Application of computer-assisted interviews to sexual behavior research. American Journal of Epidemiology, 149, 950–954.

    Article  PubMed  Google Scholar 

  29. Kraut-Becher, J. R., & Aral, S. O. (2003). Gap length: An important factor in sexually transmitted disease transmission. Sexually Transmitted Diseases, 30, 221–225.

    Article  PubMed  Google Scholar 

  30. Lepkowski, J. M., Mosher, W. D., Davis, K. E., Groves, R. M., & Van Hoewyk, J. (2010). The 2006–2010 National Survey of Family Growth: Sample design and analysis of a continuous survey. Vital and Health Statistics (Series 2). Data Evaluation and Methods Research, 150, 1–36.

    PubMed  Google Scholar 

  31. Levant, R. F., Rankin, T. J., Hall, R. J., Smalley, K. B., & Williams, C. M. (2012). Measurement of nontraditional sexuality in women. Archives of Sexual Behavior, 41, 283–295.

    Article  PubMed  Google Scholar 

  32. Marrazzo, J. M. (2000). Sexually transmitted infections in women who have sex with women: Who cares? Sexually Transmitted Infections, 76, 330–332.

    PubMed Central  Article  PubMed  Google Scholar 

  33. Marrazzo, J. M. (2004). Barriers to infectious disease care among lesbians. Emerging Infectious Diseases, 10, 1974–1978. doi:10.3201/eid1011.040467.

    PubMed Central  Article  PubMed  Google Scholar 

  34. Marrazzo, J. M., Coffey, P., & Bingham, A. (2005). Sexual practices, risk perception and knowledge of sexually transmitted disease risk among lesbian and bisexual women. Perspectives on Sexual and Reproductive Health, 37, 6–12. doi:10.1363/3700605.

    PubMed Central  Article  PubMed  Google Scholar 

  35. Marrazzo, J. M., Koutsky, L. A., & Handsfield, H. H. (2001). Characteristics of female sexually transmitted disease clinic clients who report same-sex behaviour. International Journal of STD AIDS, 12, 41–46.

    Article  PubMed  Google Scholar 

  36. Marrazzo, J. M., Koutsky, L. A., Kiviat, N. B., Kuypers, J. M., & Stine, K. (2002). Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women. Journal of Lower Genital Tract Disease, 6, 61. doi:10.1097/00128360-200201000-00017.

    Article  Google Scholar 

  37. Marrazzo, J. M., Koutsky, L. A., Stine, K. L., Kuypers, J. M., Grubert, T. A., Galloway, D. A., … Handsfield, H. H. (1998). Genital human papillomavirus infection in women who have sex with women. Journal of Infectious Diseases, 178, 1604–1609.

    Article  PubMed  Google Scholar 

  38. Marrazzo, J. M., Thomas, K. K., Fiedler, T. L., Ringwood, K., & Fredricks, D. N. (2010). Risks for acquisition of bacterial vaginosis among women who report sex with women: A cohort study. PLoS ONE, 5, e11139. doi:10.1371/journal.pone.0011139.

    PubMed Central  Article  PubMed  Google Scholar 

  39. Mayer, K. H., Bradford, J. B., Makadon, H. J., Stall, R., Goldhammer, H., & Landers, S. (2008). Sexual and gender minority health: What we know and what needs to be done. American Journal of Public Health, 98, 989–995. doi:10.2105/AJPH.2007.127811.

    PubMed Central  Article  PubMed  Google Scholar 

  40. Morris, M. (2001). Concurrent partnerships and syphilis persistence: New thoughts on an old puzzle. Sexually Transmitted Diseases, 28, 504–507.

    Article  PubMed  Google Scholar 

  41. Morris, M., & Kretzschmar, M. (1995). Concurrent partnerships and transmission dynamics in networks. Social Networks, 17, 299–318.

    Article  Google Scholar 

  42. Morrison-Beedy, D., Carey, M. P., & Tu, X. (2006). Accuracy of audio computer-assisted self-interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior. AIDS and Behavior, 10, 541–552. doi:10.1007/s10461-006-9081-y.

    PubMed Central  Article  PubMed  Google Scholar 

  43. Mosher, W. D., Chandra, A., & Jones, J. (2005). Sexual behavior and selected health measures: Men and women 15–44 years of age, United States, 2002. Advance Data from Vital Health Statistics of the National Center for Health Statistics, 362, 1–55.

    PubMed  Google Scholar 

  44. Rich, A. (2004). Reflections on compulsory heterosexuality. Journal of Women’s History, 16, 9–11.

    Article  Google Scholar 

  45. Sandfort, T. G., & Dodge, B. (2008). “And then there was the down low”: Introduction to Black and Latino male bisexualities. Archives of Sexual Behavior, 37, 675–682. doi:10.1007/s10508-008-9359-4.

    PubMed Central  Article  PubMed  Google Scholar 

  46. Savin-Williams, R. (2008). Refusing and resisting sexual identity labels. In D. L. Browning (Ed.), Adolescent identities: A collection of readings (pp. 67–91). New York: Analytic Press.

    Google Scholar 

  47. Schmidt, A. B. (2010). Prevalence, predictors and negative outcomes associated with discordant sexual identity, sexual attraction and sexual identity. Unpublished doctoral dissertation, The City University of New York, New York.

  48. Siegel, K., & Schrimshaw, E. W. (2000). Coping with negative emotions: The cognitive strategies of HIV-infected gay/bisexual men. Journal of Health Psychology, 5, 517–531. doi:10.1177/135910530000500409.

    Article  PubMed  Google Scholar 

  49. Singh, D., Fine, D. N., & Marrazzo, J. M. (2011). Chlamydia trachomatis infection among women reporting sexual activity with women screened in family planning clinics in the Pacific Northwest, 1997 to 2005. American Journal of Public Health, 101, 1284–1290.

    PubMed Central  Article  PubMed  Google Scholar 

  50. Skinner, C. J., Stokes, J., Kirlew, Y., Kavanagh, J., & Forster, G. E. (1996). A case-controlled study of the sexual health needs of lesbians. Genitourinary Medicine, 72, 277–280.

    PubMed Central  PubMed  Google Scholar 

  51. Szymanski, D. M., Kashubeck-West, S., & Meyer, J. (2008). Internalized heterosexism: A historical and theoretical overview. The Counseling Psychologist, 36, 510–524. doi:10.1177/0011000007309488.

    Article  Google Scholar 

  52. Tang, H., Greenwood, G. L., Cowling, D. W., Lloyd, J. C., Roeseler, A. G., & Bal, D. G. (2004). Cigarette smoking among lesbians, gays, and bisexuals: How serious a problem? (United States). Cancer Causes and Control, 15, 797–803. doi:10.1023/B:CACO.0000043430.32410.69.

    Article  PubMed  Google Scholar 

  53. Tao, G. (2008). Sexual orientation and related viral sexually transmitted disease rates among US women aged 15 to 44 years. American Journal of Public Health, 98, 1007–1009.

    PubMed Central  Article  PubMed  Google Scholar 

  54. Thompson, E. M., & Morgan, E. M. (2008). “Mostly straight” young women: Variations in sexual behavior and identity development. Developmental Psychology, 44, 15–21. doi:10.1037/0012-1649.44.1.15.

    Article  PubMed  Google Scholar 

  55. Vrangalova, Z., & Savin-Williams, R. C. (2012). Mostly heterosexual and mostly gay/lesbian: Evidence for new sexual orientation identities. Archives of Sexual Behavior, 41, 85–101. doi:10.1007/s10508-012-9921-y.

    Article  PubMed  Google Scholar 

  56. Warner, M. (1991). Introduction: Fear of a queer planet. Social Text, 29, 3–17.

    Google Scholar 

  57. Xu, F., Sternberg, M. R., & Markowitz, L. E. (2010a). 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. Sexually Transmitted Diseases, 37, 407–413. doi:10.1097/OLQ.0b013e3181db2e18.

    PubMed  Google Scholar 

  58. Xu, F., Sternberg, M. R., & Markowitz, L. E. (2010b). Men who have sex with men in the United States: Demographic and behavioral characteristics and prevalence of HIV and HSV-2 infection: Results from National Health And Nutrition Examination Survey 2001–2006. Sexually Transmitted Diseases, 37, 399–405. doi:10.1097/OLQ.0b013e3181ce122b.

    PubMed  Google Scholar 

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Correspondence to Kate L. Lapane.

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Nield, J., Magnusson, B., Brooks, C. et al. Sexual Discordance and Sexual Partnering Among Heterosexual Women. Arch Sex Behav 44, 885–894 (2015). https://doi.org/10.1007/s10508-014-0287-1

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Keywords

  • Sexual orientation
  • Same sex partners
  • Sexual concurrency
  • Serial monogamy