This paper examines sexually transmitted disease (STD) transmission risks among lesbian and bisexual women, a population that has received comparatively little research attention. Drawing on epidemiological studies and health assessments, the paper identifies specific sexual practices that facilitate transmission — including shared sex toys, oral sex, and inadequate hygiene — and highlights the widespread misconception that lesbian women face minimal STD risk. The discussion covers bacterial vaginosis, HIV, HPV, herpes, and trichomoniasis, while also addressing gaps in clinical practice and community education. The paper concludes by calling for improved patient-provider communication, targeted health education, and greater awareness within the lesbian and bisexual community.
Sexual practices across all groups have been scrutinized since the first discovery of HIV/AIDS. Most research in this area has focused on gay and bisexual men and the transmission of sexually transmitted diseases (STDs) and HIV/AIDS. However, there is another population that carries a meaningful risk of STD transmission and has not been studied extensively: lesbian and bisexual women.
There is not an abundance of information on this particular group. There are approximately 2.3 million lesbians in the United States (Institute of Medicine, 1990). Within this population, reports exist of STD transmission involving genital herpes, trichomoniasis, HIV, and HPV (human papillomavirus) (Marrazzo, Coffey, & Bingham, 2005). These reports generally come from group studies or responses to specific questions about sexual practices and health concerns. There is little evidence that general practitioners or gynecologists actively seek to determine the sexual practices of their patients or ask questions related to the specific health concerns of lesbian women. One reason for this may be a commitment to respecting patient privacy; another is likely the lack of professional education regarding lesbian sexual practices and the resulting incidence of STDs.
A significant concern related to lesbian and bisexual sexual health is the transmission of bacterial vaginosis. Bacterial vaginosis is the most common cause of vaginal complaints among women in the United States during their reproductive years, and its incidence is particularly high among lesbian and bisexual women (Hillier & Holmes, 1999). The precise cause of this infection is not fully understood, but vaginal secretions shared between partners make it an easily transmitted condition. Bacterial vaginosis can lead to pelvic inflammatory disease, increase a person's vulnerability to contracting HIV or gonorrhea, and create complications during pregnancy.
The overall increase in STDs observed in the lesbian and bisexual community raises important questions about how transmission is occurring. Before specific prevention methods can be addressed, understanding what is driving this trend is essential.
Several sexual practices contribute to STD transmission between lesbian and bisexual women. Using and sharing sex toys — such as dildos and other penetrative devices — without cleaning them between partners is a key transmission pathway, as vaginal fluids that may carry infection are passed directly from one partner to another. The same risk applies to anal penetration. Oral sex is another source of transmission, particularly from oral-vaginal contact and subsequent mouth-to-mouth kissing. Body-to-body rubbing can also result in the exchange of vaginal fluids. Additionally, failure to wash hands during sexual activity contributes to risk.
As with heterosexual and gay male sexual behavior, engaging in sex with unknown partners significantly increases risk. Not knowing a partner's sexual history raises the likelihood of contact with someone who has been exposed to HIV — a concern that is especially relevant for bisexual women. Risky behavior occurs across all sexual orientations, and the use of drugs and alcohol compounds these risks by lowering inhibitions, increasing the likelihood of multiple partners, and reducing attention to hygiene during sexual activity.
"Study findings on risk awareness and hygiene practices"
"Call for better education and communication"
You’re 49% through this paper. Sign up to read the remaining 2 sections.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.