Women Who Have Sex With Women Research Articles

Italian women who have sex with women: prevalence and co-occurrence of sexual practices.

Sexuality research on the sexual practices of women who have sex with women (WSW) has thus far mostly centered on risk factors and addressed a limited number of practices, with a focus on oral sex and insertive vaginal sex. This study arises from the need to fill such a significant gap, which prevents researchers, clinicians, and policy makers from being adequately up-to-date on the sexual habits and tendencies of this population. A multiple-choice questionnaire was completed by 723 WSW with a mean (SD) age of29.14 (6.94) years. The survey included closed questions on sexual practices, including genital and oral sex, but also nongenital sexual contact (petting and intercrural sex), anal sex, and kinky practices. The most common sexual practices were self-masturbation (99.03%), oral sex (performed or received, 98.20%), and insertive genital sex (performed or received, 89.07%). Half of our sample had tried kinky practices at least once in a lifetime (51.31%). Respondents tended to experiment sexually more with stable partners rather than with casual ones. Comparisons among practices in the lesbian and bisexual population are presented. Providers should be aware that sexual orientations have their own specificities, including sexuality and practices, which should increase their knowledge and comfort in working with sexual minorities. The novel topic of the study addresses the gap in sexuality research among WSW. Strengths include the sex-positive approach, the inclusion of an array of sexual practices, and the consideration of the specificities of the group. Limitations in the generalization of the results are the cross-sectional design and the explicit topic, which may have kept some persons from responding. We propose the framing of sex as going beyond genital contact, and we invite clinicians and researchers who come into contact with WSW to be aware that sexual orientation can be associated with specificities regarding sexuality and sexual practices.

Psychometric Analysis of Personal Anxiety and Students' Academic Achievement in Universities in Cross River State, Nigeria

Social behavioral change communication interventions in Tanzania target populations engaging in high- risk sex behaviors and practices: anal intercourse, sex work, injecting drugs and male same sex relationships excluding women who have sex with women (WSW) or women who identify lesbians. In this paper, I describe terms used in reference to female same-sex sex or sexual relationships, important in health social behavior change communication targeting WSW in Tanzania. Data presented are part of cross-sectional descriptive and retrospective formative study among WSW conducted in Dar-es-Salaam region, Tanzania in 2021. WSW aged 18 and above, stayed in Dar-es-Salaam for six months or more; had had sexual contact with a woman in the past year. Participants were recruited via snowball method. Community leaders/members and managers of NGOs/institution supporting WSW were purposively selected to take part in this study. Researchers used four methods to generated data needed for this study: focus group discussion, in-depth interviewing, observation and collecting WSW’s life stories. Content data analysis was conducted to create categories of terms around female same-sex sex or sexual relationships reported by study participants. Four categories of terms around female same-sex sex or sexual relationships emerged: terms referring to women who identify WSW or lesbians; terminologies referring to female same-sex sex; terms referring to female same-sex-related behaviors and practices; and terminologies referring to items/materials used during female same-sex sex. I conclude WSW in Dar-es-Salaam have coined terms that express their socially- created world. I recommend social behavior change communication programmers in the health education and promotion context to use these terms in developing comprehensive and WSW-friendly research protocols for sustainable behavior change among WSW and the public towards making female same-sex sex safe for reduced HIV and STIs transmission in ..

Drug use and sexual behavior during COVID-19 lockdown in Australia

ABSTRACT Objective To examine the impact of COVID-19 lockdown on drug consumption and sexual behaviors, among people living in Australia. Methods Retrospective data analysis via logistic regression of 806 responses from an online, cross-sectional survey conducted during August 2020 was performed. State was a proxy for lockdown (Victoria = lockdown, other states = no lockdown). Results Some participants increased drug usage from 2019–2020: 25.0% for alcohol, followed by marijuana (11.0%), other drugs (8.9%), and tobacco (7.0%). Risk factors for increasing use included women who have sex with women (WSW) and unsecure employment; protective factors included being in a relationship. TAFE/Diploma/Certificate level education was a risk factor for tobacco use, but a protective factor for alcohol use. There was a strong association between drug use and high-risk sexual behaviors. Multivariable analysis found no significant difference in patterns of drug use in Victoria (lockdown), relative to other states (without lockdown). Conclusion Several risk factors for drug use were identified, and high-risk sexual behaviors were associated with drug use. However, given the lack of difference between Victoria and other states, it is unclear if these changes are attributable to lockdown. Further research could explore the nature/causes of these changes, to inform future pandemic preparedness.

Terms around Female Same-Sex Sexual Relationships: Resource for Social Behavior Change Communication Interventions Targeting Women Who Have Sex with Women in Tanzania

Social behavioral change communication interventions in Tanzania target populations engaging in high- risk sex behaviors and practices: anal intercourse, sex work, injecting drugs and male same sex relationships excluding women who have sex with women (WSW) or women who identify lesbians. In this paper, I describe terms used in reference to female same-sex sex or sexual relationships, important in health social behavior change communication targeting WSW in Tanzania. Data presented are part of cross-sectional descriptive and retrospective formative study among WSW conducted in Dar-es-Salaam region, Tanzania in 2021. WSW aged 18 and above, stayed in Dar-es-Salaam for six months or more; had had sexual contact with a woman in the past year participated in this study. Participants were recruited via snowball method. Community leaders/members and managers of NGOs/institution supporting WSW were purposively selected to take part in this study. Researchers used four methods to generated data needed for this study: focus group discussion, in-depth interviewing, observation and collecting WSW’s life stories. Content data analysis was conducted to create categories of terms around female same-sex sex or sexual relationships reported by study participants. Four categories of terms around female same-sex sex or sexual relationships emerged: terms referring to women who identify WSW or lesbians; terminologies referring to female same-sex sex; terms referring to female same-sex-related behaviors and practices; and terminologies referring to items/materials used during female same-sex sex. I conclude WSW in Dar-es-Salaam have coined terms that express their socially- created world. I recommend social behavior change communication programmers in the health education and promotion context to use these terms in developing comprehensive and WSW-friendly research protocols for sustainable behavior change among WSW and the public towards making female same-sex sex safe for reduced ....

Sexual behavior and self-declaration of sexual orientation among people 18–64 years in Brazil: results from the Knowledge, Attitudes, and Practices survey, 2013 and the National Health Survey, 2019

BackgroundPopulation surveys involving the monitoring of high-risk sexual behavior have been recognized as important public health tools to control the HIV epidemic and other sexually transmitted infections (STIs).MethodsUsing data from the Knowledge, Attitudes, and Practices survey (PCAP-2013) and from the National Health Survey (PNS-2019), indicators of sexual behavior were compared according to sociodemographic characteristics among individuals aged 18–64 years, including size (%) estimates of men who have sex with men (MSM) and women who have sex with women (WSW). Specifically, the PNS-2019 prevalence estimates of homosexual, bisexual, heterosexual males and females were compared with those from the PCAP-2013. To compare PCAP and PNS proportional distributions, the Pearson's chi-square test, adjusted by the Rao-Scott’s correction, was applied.ResultsSize (%) estimates of MSM and WSW obtained by direct questions from the PCAP-2013, showed higher homosexuality prevalence estimates than those resulting from the PNS-2019 self-declared sexual orientation. Significant differences were found between the MSM proportions according to the PCAP-2013 (3.7%; 95% CI 3.1–4.4%) and to the PNS-2019 (2.2%; 95% CI 1.9–2.5), and between the WSW proportions (4.6%; 95% CI 4.0–5.4%) and (2.1%; 95% CI 1.8–2.4), respectively. Results from both surveys showed MSM and WSW prevalence estimates increase with educational level, decrease with age, and is larger among people who do not live with partner, live in urban areas and in state capitals. Regarding condom use at last sexual intercourse, no differences between the PCAP-2013 and the PNS-2019 estimates were found at the national level, but significant improvements were found for MSM, people aged 18–24 and 25–34 years, and individuals not living with a partner.ConclusionsThe underestimation of MSM and WSW prevalence by self-declared sexual orientation suggests that sexual minorities face many difficulties related to disclosing their sexuality and reinforces the importance of developing public health interventions for changing population attitudes and promoting sexual orientation disclosure. Moreover, the low use of condoms in both surveys (PCAP-2013 and PNS-2019) carried out 6 years apart highlights the need of public policies to expand prevention strategies for HIV infection and other STIs.

Santé sexuelle et reproductive des femmes ayant des rapports sexuels avec des femmes en Suisse

Sexual and reproductive health (SRH) of lesbians and other women who have sex with women (WSW) remains largely unexplored in Switzerland. A cross-sectional web- and pa-per-based survey was conducted in 2012. The aim of this study was to gain more knowledge on the SRH of the WSW in French-speaking Switzerland in order to inform preventive activities and promote more adequate SRH services for these women. Sexual practices between women are very diverse, some of them potentially risky in terms of transmitting various STIs, but 71% of WSW never practice safer sex or other risk reduction strategies for HIV and other STIs with their female partners. Only 69% have had a gynecological check-up in the last 3 years. 16% had one or more children. 29% reported having experienced violence in a lesbian relationship. Specific information on SRH should be developed to match the specificities and needs of WSW and more research is needed on their SRH, their risk regarding breast cancer and ways to improve the cultural sensitivity and knowledge of gynecologists and other health care providers towards their lesbian, bisexual and other WSW patients.

Gynecological Care Among Brazilian Women Who Have Sex with Women: A Respondent-Driven Sampling Study.

Purpose: This study aimed to describe the gynecological care provided to Brazilian women who have sex with women (WSW). Methods: Respondent-driven sampling was used to recruit Brazilian WSW. The survey questions, concerning gynecological care, were designed in Portuguese by medical professionals, medical students, and LGBTQIA+ community members, including the authors. The statistical analyses were weighted to account for the likelihood of recruitment. Results: From January to August of 2018, 299 participants were recruited in 14 recruitment waves. The mean age of the WSW was 25.3 years. Most (54.9%) identified as lesbian and had been involved in past-year sexual intercourse mainly with cisgender women (86.1%). The WSW also reported having sex with cisgender men (22.2%), transgender men (5.3%), nonbinary people (2.3%), and transgender women (5.3%) in the last year. More than a quarter of the WSW did not have regular appointments with a gynecologist: 8.0% (95% confidence interval [CI] = 4.2-11.6) and 19% (95% CI = 12.8-25.2) stated that they had never gone to the gynecologist or they had only gone for emergencies, respectively. Almost one-third had never had cervical cancer screening (cervical cytology, Pap test or Pap smear). Most women justified avoiding the test because they felt healthy, thought it would hurt, or feared a health professional might mistreat them. Conclusion: Gynecologists should avoid heteronormative assumptions, inquire about sexual practices, orientation, and identity separately, and provide Pap tests as advised to WSW.

Different Categorizations of Women's Sexual Orientation Reveal Unique Health Outcomes in a Nationally Representative U.S. Sample.

Sexual minority women (i.e., women minoritized for their sexualities) are identified as high risk for mental health and substance use problems; however, there is no consensus on the criteria by which women are categorized as sexual minority. Though there is some evidence suggesting that certain subgroups of women are at higher risk than others based on sexual orientation, different categorization schemes for sexual orientation have yet to be compared within the same sample. Using data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (N=19,528), we examined how multiple categorization schemes (i.e., identity, behavior, recency of sexual behavior) for categorizing women who have sex with women (WSW) yield different estimates of prevalence of mental health and substance use issues. We used chi-square and logistic regression to analyze the link between sexual orientation categorization schemes and health, categorizing by 1) self-identification only, 2) behavior only, and 3) the combination of self-identification and behavior (recent vs. past). We discovered high prevalence rates of health problems among heterosexual-identified WSW who reported no recent sexual activity with women (i.e., previously had sex with women but not within the past 12months); this category of women comprised 35% of all WSW. Step by step, we found more detailed information about these women's experiences by moving to the complex categorization scheme (the combination of self-identification and behavior). Heterosexual-identified women who have had sex with women in their past (though not recently) presented as a large group with high prevalence rates of substance use and mental disorders. These women remain invisible to researchers who categorize sexual orientation only by sexual identity or by behavior and ignore the role of behavior change over time-imprecisely categorizing such women as heterosexual or as women who have sex with men. They thus are underserved by health research and represent a significant population for further study and intervention.

Are women-who-have-sex-with-women an 'at-risk' group for cervical cancer? An exploratory study of women in Aotearoa New Zealand.

International research consistently indicates that women-who-have-sex-with-women (WSW) are less likely to engage in cervical screening than heterosexual women. In the main, studies have explored rates of engagement and highlighted some reasons for non-engagement. This study extends on this work by exploring perceptions among sexual minority women (WSW) for lower rates of engagement among WSW more generally and is the first study on this topic undertaken in Aotearoa New Zealand. A sample of 177 self-identified WSW domiciled in New Zealand completed an online survey about their engagement in cervical screening, reasons for engaging (or not) in cervical screening, and perceptions of why SMW might be less likely to engage in cervical screening. Fewer than half of participants had engaged in cervical screening every 3years as recommended, with women who had only ever had sex with other women being significantly less likely to have engaged in screening. A lack of clear information about risk relative to sexual history, heteronormativity, and the invasive nature of screening were the dominant reasons for lower engagement among WSW. A legacy of misinformation, and endemic heteronormativity in public health messaging around cervical screening is a significant barrier to engagement in screening for WSW. To increase engagement in screening among WSW, public health information needs to specifically address the needs of WSW.

Adverse pregnancy and birth outcomes in sexual minority women from the National Survey of Family Growth

Few studies have examined how multiple marginalized identities are associated with adverse pregnancy and birth outcomes, especially for Black and Hispanic sexual minority women. Sexual minorities are people who identify as lesbian, gay, bisexual or transgender (LGBT). The purpose of this study was to examine differences in adverse pregnancy (i.e., miscarriage) and birth outcomes (i.e., preterm birth, low birthweight, and stillbirth) in a national sample of women by race and ethnicity, and sexual minority status (LGBT identification and same-sex sexual behavior). We conducted a cross-sectional analysis of the National Survey of Family Growth (NSFG). The unit of analysis was pregnancy, not participants. In this study, we examined pregnancies to participants who identified as heterosexual, lesbian, and bisexual, by race and Hispanic ethnicity. We also studied sexual behaviors to categorize participants as women who have sex with women (WSW) and women who have sex with men (WSM). Outcomes included preterm birth, low birthweight, miscarriage, and stillbirth. We employed logistic and linear regression analyses for analyses using STATA. We studied 53,751 pregnancies, and 9% of these occurred in people who identified as heterosexual, but had engaged in sexual activity with a female partner (heterosexual-WSW), 7% in those identifying as bisexual, and 1% to women who identified as lesbian. Pregnancies ended in preterm birth (10.7%) and low birthweight (9.0%), stillbirths (2-4%), and miscarriages (17-21%) in sexual minority women. We observed that pregnancies reported by Hispanic lesbian women had a higher birthweight (β = 10.71, SE = 4.1, p-value = 0.01) compared to infants born to Hispanic heterosexual-WSM. Pregnancies to lesbian women were significantly more likely to end in stillbirth (aRR = 3.58, 95% CI 1.30,9.79) compared to heterosexual-WSM. No significant differences were noted in risk of adverse birth outcomes by sexual orientation for NH Black or Hispanic women. In this sample, preterm births were less likely to occur among heterosexual-WSW than in heterosexual-WSM. Pregnancies to lesbians and bisexual women were more likely to end in miscarriage or stillbirth than heterosexual WSM. Lesbian Hispanic women reported higher birthweights compared to heterosexual-WSM Hispanic women. More research should be done to further understand these findings.

Exploring Factors Affecting Patient–Provider Interactions and Healthcare Engagement Among a Diverse Sample of Women Who Have Sex with Women in New York City

Women who have sex with women (WSW) have lower rates of engagement in health care and preventive screenings than women who have sex exclusively with men. Existing literature provides limited insight into how intersecting and overlapping identities, such as race, ethnicity, sexual orientation, gender identity, and identities related to gender expression, may shape individuals’ experiences within health care. We conducted qualitative interviews in New York City with 30 people who identified as women, reported sex with people who identify as women, were age 18–65, and were diverse in race, ethnicity, and sexual orientation and gender identity. The semi-structured questionnaire asked participants about positive and negative healthcare experiences to elicit what could encourage or prevent seeking care, with a focus on provider-related factors. Factors that led to positive healthcare experiences included having a provider who was knowledgeable about LGBTQ experience and health and who affirmed their sexuality, gender identity, and other intersecting identities. Factors that contributed to negative healthcare experiences included poor interactions with providers, and providers’ perceived heteronormativity and lack of awareness of WSW healthcare needs. WSW of different races, ethnicities, sexual orientations, and gender identities seek validating healthcare experiences that acknowledge and affirm their identities. We present a visual summary of the main thematic factors that contributed to positive and negative WSW healthcare experiences. Increasing access to care requires training providers on how to engage WSW patients, including WSW of diverse race/ethnicity and gender identity and expression.

Humour Against Binge Drinking During the COVID-19 Pandemic: A Cartoon-Based Anti-Alcohol Health Campaign Targeting Women-Who-Have-Sex-With-Women

This study focuses on the role of humour in health and well-being of women-who-have-sex-with-women (WSW) during COVID-19. This group has been shown to be vulnerable to alcohol abuse, especially as self-medication coping with social consequences of the COVID-19 pandemic. We investigated the potential usefulness of WSW-inclusive (i.e., depicting a female-female romantic couple) versus hetero-normative (i.e., depicting a male-female romantic couple) humorous cartoons in an anti-alcohol health campaign against excessive drinking among WSW. One-hundred-and-twenty-seven self-categorized WSW of diverse genders (woman, non-binary) and sexual orientations (e.g., lesbian, bisexual, pansexual, queer, heterosexual) participated in a 2 × 2 factorial between-participants design. Data were collected during the first months of the COVID-19 pandemic in The Netherlands. Humorous cartoons explicitly referring to lockdown measures systematically varied the humour subject (punchline about excessive drinking versus staying sober) and the couple (male-female, female-female) that were depicted. Although the (very brief) health message did not influence binge drinking determinants, the humorous health campaign depicting a female-female couple was perceived as more inclusive and evoked more amusement and less anger than when the cartoons depicted a male-female couple. High WSW identifiers were less amused about the health campaign text (but not the cartoons), less likely to share campaign materials offline (but not online), and had more positive binge drinking attitudes but lower binge drinking intentions than low identifiers. Implications are discussed.

HIV and STI Prevention Among Spanish Women Who have Sex with Women: Factors Associated with Dental Dam and Condom Use

The scientific community has systematically ignored the needs of women who have sex with women (WSW). The invisibilization of romantic and sexual relationships between women has caused a profound lack of knowledge about the impact of HIV and other STIs on this population subgroup. This study aims to analyze the frequency of dental dam and condom use in WSW and identify the variables that explain the use of these two preventive methods. The sample is composed of 327 women aged between 18 and 60 years (M = 27.82; SD = 8.10). The results indicate that only 4.7% of those who practice cunnilingus and 5.2% of those who practice anilingus report “always” using dental dam (systematic use). Condoms are used systematically by 37.1% of those who practice vaginal penetration and 37.8% of those who practice anal penetration. Age, high perceived self-efficacy, and adequate assertive communication skills are variables significantly related to preventive behavior. The severity attributed to HIV and the perceived risk of infection are protective factors regarding dental dam use. For condom use, high levels of internalized homophobia and drug use are risk factors. Future preventive strategies should provide information on preventive strategies to WSW who, for different reasons, are not involved in LGBT contexts or associations and, therefore, do not have access to training activities and mistakenly believe that they are invulnerable as they do not have sexual relations with men.

Heterosexual Identification and Same-Sex Partnering: Prevalence and Attitudinal Characteristics in the USA.

This paper used the 2011-2017 National Survey of Family Growth to estimate population sizes and attitudinal characteristics of heterosexual-identified men who have sex with men (MSM) and women who have sex with women (WSW) aged 15-44 years. Analyses estimated population sizes in stages: after excluding respondents who reported only one lifetime same-sex partner, which happened before the age of 15; after excluding males who reported nonconsensual male-male sex; after excluding respondents who reported only one lifetime same-sex partner, regardless of the age at which that experience occurred; after excluding respondents who reported only two lifetime same-sex partners, the first of which occurred before age 15; and after excluding males who reported male-male sex work. The broadest criteria included many individuals with limited same-sex sexual histories or those who experienced nonconsensual sex or potentially coerced sex in youth. After excluding those respondents, analyses showed that heterosexual-identified MSM and WSW had a diversity of attitudes about gender and LGB rights; only a distinct minority were overtly homophobic and conservative. Researchers should carefully consider whether to include respondents who report unwanted sexual contact or sex at very young ages when they analyze sexual identity-behavior discordance or define sexual minority populations on the basis of behavior.

Reported Profiles of Women Who Have Sex with Women in Dar-es-Salaam, Tanzania

Aims: This study explored socio-economic characteristics, sexual and health behaviour of women who have sex with women (WSW) in Tanzania. The study was conducted to increase public and policy-makers awareness about WSW characteristics, findings may be useful in planning essential public health interventions targeting the WSW.
 Methodology: We involved WSW and community leaders in this study. We used a cross-sectional descriptive formative design and conducted the study in Ilala, Kinondoni and Temeke districts in Dar-es-Salaam Region in Tanzania. We performed data collection through focus group discussion (FGD), in-depth interviews (IDIs), key informant interviews (KIIs) and life stories. We applied inductive thematic analysis where open coding approach was adopted using participants’ language. We employed grounded theory approach in the analysis.
 Results: WSW in Tanzania belong to various sexual groups including lesbian, transgender, tomboy and bisexual. Although sex between women is practiced by women of all ages, it is most common among young women. It is practiced by married women and women with children and commonly starts during Secondary School. WSW are of varying socio-economic status (education and income) with some WSW facing poorer socio-economic status due to rejection, stigma and discrimination propagated by family and the wider community. WSW engage in risky behaviours, sexual and other health-related behaviours such as promiscuity, transactional sex, alcoholism, smoking, and drug abuse.
 Conclusion: WSW are of varying socio-economic characteristics, sexual and health behaviours. This may mean unique public health needs for different WSW and thus calling for tailored health education, health promotion, as well as socio-economic interventions to improve health-related behaviours, for better health outcomes of the WSW.

Anal Sex and Sexual Function Satisfaction: A Comprehensive (and Critical) Review of Current Medical Literature

ABSTRACT Introduction Anal sex is practiced by people of all sexualities, genders and bodies. Despite common practice, there is relatively little in the clinical literature about anal sex from a more sex-positive “sexual health” perspective. Objective To review the medical literature related to anal intercourse, with attention to the fraction that focuses on the sex positive aspects of anal sex to address and support the sex-based questions and concerns of adults who practice it. Methods A comprehensive literature review was conducted in accordance with PRISMA guidelines, using PubMed. For our search, we generated a comprehensive list of synonyms for anal intercourse and combined them with synonyms for sex positivity (sexual satisfaction, erogenous, pleasure, and orgasm). Results We identified a total of 149 articles from the search terms. Of these articles, 59 abstracts were relevant to include and were reviewed. Among these abstracts, 23 manuscripts were reviewed in full and only 20 of these were acceptable for inclusion in this review. Twelve of the twenty papers included in our review were primarily sexual health focused, while the other eight primarily pathology focused. Men who have sex with men (MSM) is the population most considered within the discussion of anal sex. There was a trend towards identifying the influence of external factors on the sexual outcomes of anal sex in MSM, such as condom use, lubricant use, prostate cancer, and drug use. Among women who have sex with men (WSM), 28.4% described the first experience as pleasant and 62.3% continued to practice anal sex. However, almost half of WSM found their first experience to be too painful to continue. Women who have sex with women (WSW) were missing from the discussion of anal sex and sexual health. Conclusions Though the medical literature contains an abundance of studies of “sexual pleasure” and “sexual function” these are commonly hetero-normative and focus on penile-vaginal intercourse, and very rarely include anal stimulation/sex. Given that anal sex is widely practiced, the dearth of sex-positive literature focused on anal sex suggests both that patient's practices of anal sex is less commonly queried by providers, and, that there is a need for medical literature to help inform providers and patients about how to make anal sex safer and more satisfactory. Second to the general U.S. population, other small but important subgroups for whom this is relevant include cancer survivors working to recover their sexual health, and transgender women awaiting gender affirming genital surgery. There is a need for more investigation into the sex positive nature of anal sex. Disclosure No

Gaps in sexual health research about women who have sex with women. A scoping review

ObjectiveTo know the characteristics of the studies that have paid attention to women who have sex with women (WSW) and to identify possible gaps in the interest of comprehensive sexual health in WSW. MethodA scoping review on sexual health on WSW was conducted from 2000 to 2019. Papers with lack of focus on sexual health on WSW were excluded and a web tool was used to guarantee blindness. Information was extracted on the key characteristics of the studies and the quality of the evidence. The sexual health categories were comprehensive sexual health, specification of sexual practices in WSW, and recommendations provided. Results39 studies were included, mostly cross-sectional. The gaps identified were the lack of evidence on sexual health, confusion about sexual orientation and sexual practices, lack of specific interest in comprehensive sexual health and the life cycle approach. Recommendations focused on WSW self-care; interventions aimed at clinical practice, research, education and prevention; and contributions of a feminist approach on sexual health of WSW. ConclusionsThere are several gaps about in the knowledge about sexual health among WSW. Self-care improvement and specific strategies addressed to the unique characteristics of these women and their different and specific situation and health determinants are highlighted.

Sexual behaviors of women who have sex with women: A qualitative explorative study

Sexual transmitted infections (STIs), including the human papillomavirus, are transmissible by female-to-female sexual contact, even though a common misperception is that women who have sex with women (WSW) are at lower risk for STIs. This study sought to further understand current sexual behaviors and protective mechanisms utilized by WSW. Incorporating a grounded theory approach, nineteen (N = 19) semistructured telephone interviews were conducted among WSW from four regions of the United States. Findings indicate that WSW were engaging in risky sexual behaviors due to limitations in knowledge, aversion to dental dams, gender bias, and perceived emotional connection. Implications suggest comprehensive sexuality education and community-based risk reduction education programs.

10.54111/0001/NNN4

According to the Williams Institute, there are over 13 million individuals, age 13 and older, that identify as lesbian, gay, bisexual, or transgender. 1 There are 3.5% of adults or estimated 9 million adults, in the United States, identify as lesbian, gay, or bisexul.3 In the same survey, 1.8% of adults identified as bisexual and 1.7% of adults identify as gay or lesbian.3 In the United States, there is an estimated 646,500 same sex couples with 54% being female.2 There is an estimated 19 million Americans who have engaged in same-sex behavior.2 The number of women who have sex with women (WSW) is increasing due to the increase in individuals identifying as LGBTQ+.4

“Women trade sex from women in Tanzania”: findings from qualitative formative research with women who have sex with women in Dar-es- Salaam City

Recent studies indicate women are increasingly willing to pay for sex from both men and women. Most of these studies have mainly focused on the developed world and little is known about women’s willingness, reasons, and motivation to pay for sex on the African continent, the East African region and in Tanzania, in particular. We explored paid sex behaviors and practices among women who have sex with women (WSW) in Dar-es-Salaam city, Tanzania. The study was designed as a formative qualitative cross-sectional study conducted in Ilala, Kinondoni and Temeke districts in Dar-es-Salaam region. Study participants included community leaders; and WSW aged 18 years and above, who had had engaged in same-sex sex in the past year or in same-sex relationship(s), and had knowledge of WSW’s lived experiences, among other criteria. Most of the WSW participants affirmed paid sex is a common practice among them with reported reasons and motivations being more-or-less similar to those documented in other parts of the world. Findings show that commercial sex is an arena for behavioral convergences, and this calls for new pathways to comprehend (women’s) behavior, sexuality, commercial sex industry and its implications to women’s sexual and reproductive health and healthcare.