Sexually Transmitted Infections and Associated Conditions Among Women Who Have Sex with Women

Abstract

Available data support that women who have sex with women (WSW) are at risk for a variety of sexually transmitted infections (STI) and vaginitis. Risk of STI transmission in this group depends on the specific STI under consideration and the sexual practices involved. Data demonstrates that WSW receive less standard gynecologic screening than their heterosexual counterparts. This may be due, in part, to provider and patient assessment of risk. Based on available evidence, there is a need to increase provider education on the sexual health of WSW. Moreover, enhancement of STI screening guidelines that specifically mention WSW, particularly for cervical cancer and infections caused by C. trachomatis, are essential.

Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among U.S. Women and Girls

“…First, lesbian-identified adolescents and young adults may not know or believe that the HPV vaccine is relevant to them. Indeed, prior research shows that, although lesbians are at risk of acquiring HPV and other STIs from female and male sexual partners throughout the life course (6, 18, 50–52), they may not perceive themselves as being at risk of HPV (15, 17) or cervical cancer (19). These risk (mis)perceptions stem from the widespread misconception among lesbians (14, 15, 17) and their health care providers (18, 53, 54) that HPV cannot be transmitted through female-to-female contact and that lesbians are not at risk of HPV from past sexual activity with men, in which the vast majority of lesbians have engaged at some point in their life (4).…”

“…Lesbian and bisexual women are at risk of HPV and cervical cancer from both female and male sexual partners throughout the life course (4–6). Indeed, HPV can be transmitted via not only penile-vaginal sexual intercourse, in which the majority of lesbians have engaged at some time in their life (4), but also skin-to-skin contact with a sexual partner of any sex (6–10).…”

“…Indeed, HPV can be transmitted via not only penile-vaginal sexual intercourse, in which the majority of lesbians have engaged at some time in their life (4), but also skin-to-skin contact with a sexual partner of any sex (6–10). Additionally, the prevalence of genital HPV infection among women with only female sexual partners is similar to that of women who have sex with men (11–13).…”

Sex of Sexual Partners and Human Papillomavirus Vaccination Among U.S. Girls and Women

“…9–18 However, despite their risk of cervical cancer, WSW are significantly less likely to have received regular Pap tests compared with women who have sex with men only. 15,19–21 Additionally, the two studies that have investigated cervical cancer screening among women with no past-year sexual partners suggest that this understudied population is also significantly less likely to receive regular Pap tests than those with only male past-year sexual partners.…”

“…Moreover, girls and women who report having no sexual partners may have engaged in behaviors that they do not conceptualize as sex 22,23 but that nonetheless increase their risk of cervical cancer. 9 …”