Abstract
Despite the considerable number of women in the United States who identify as lesbian, few data exist that address lesbians' health needs. The Institute of Medicine emphasized that data on sexually transmitted infections, Pap smear screening, and cervical dysplasia among lesbians were needed to guide clinical practice, policy development, and patient education. Use of surveillance data for this purpose is limited because risk classifications exclude same-gender sex among women or subsume it under behavior considered as higher risk. However, sexual transmission of human papillomavirus, HIV, Treponema pallidum, and Trichomonas vaginalis between women has been reported. Data indicate that lesbians receive routine Pap smear screening less frequently than is optimal. Moreover, lesbians commonly report previous pregnancy, induced abortion, and hormonal contraceptive use. Education of lesbians and their care providers should counter assumptions that sex between women confers no risk for transmission of sexually transmitted infections, and lesbians should receive Pap smears according to current guidelines.
Highlights
Acausative link between a patient’s sexual orientation and access to healthcare is not evident
Using capture enzyme-linked immunosorbent assay (ELISA) to measure type-specific antibodies to human papillomavirus (HPV), we found that 62 (47%) of subjects were seropositive for antibodies to HPV 16, and 83 (62%) were seropositive for HPV 6 [6,13]
The fact that squamous intraepithelial lesions (SIL) has been observed in women who reported no previous sex with men, one can conclude that high-risk and low-risk types of genital HPV are sexually transmitted between women and that lesbians should undergo Pap smear screening according to current national guidelines
Summary
Acausative link between a patient’s sexual orientation and access to healthcare is not evident. In its 1999 report, Lesbian Health: Current Assessment and Directions for the Future, the Institute of Medicine emphasized that more data were needed on STIs, Pap smear screening, and risk for cervical cancer in lesbians [3].
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