Lesbian and WSW Health Care

Lesbians are less likely to seek medical care because of their perceived and/or real fear of discrimination in society – particularly when consulting for medical care. It is important that you discuss your sexuality with your physician, particularly if a presumption of heterosexuality is made.

Many of the health-care concerns in lesbians are the same as for those addressed in heterosexual women.

Human Papilloma Virus (HPV) and Cervical Cancer

Women who have sex with women(WSW), undergo fewer Pap tests or cervical screening tests than heterosexual or bisexual women. One recent study documented that 13% of WSW were infected with HPV. As is discussed in the chapter on condyloma or HPV, certain strains of HPV increase the risk of progression towards cervical cancer. Routine cytology or Pap smears are able to detect early lesions, and thereby ensure adequate treatment and an effective cure of this type of cancer. WSW foregoing Pap smears or HPV testing may be at increased risk of progressive cervical cancer. Prevention is key! - once every 3 years is reasonable - discuss the frequency of Pap testing with your physician. HPV may be transmitted from woman to woman, through contact with infected vaginal secretions, genital warts and/or shared insertive sexual toys. Safer sex techniques include washing sexual toys between use and/or using a condom for toys used for penetration.

Herpes simplex – genital herpes

Genital herpes in the population of WSW is common. While type 2 genital herpes may be transmitted through genital-genital contact, or via contact with contaminated genital secretions, the most common infection is type 1 herpes transmitted from a "cold-sore" to the genital region. Remember, a "cold-sore" is a type of herpes and can be transmitted to the genital/anal region through direct contact particularly during an outbreak.

Hepatitis

Hepatitis A is transmitted via the fecal-oral route (contact with feces) whether direct or indirect. Transmission in WSW has been reported but has not been studied extensively. Vaccination against hepatitis A is an effective means of preventing infection – speak with your physician!

Hepatitis B is transmitted via the exchange of contaminated body fluids(vaginal secretions) or blood(cuts, wounds or menstrual flow), whether direct or indirect. Avoiding contact with blood and fluids is important if the hepatitis B status of your partner is unknown. While not studied extensively, the transmission of hepatitis B amongst WSW has been reported. Hepatitis B can be prevented with vaccination – speak to your doctor!

Hepatitis C is still being evaluated as per its risk through sexual relations. It is known that hepatitis C is primarily transmitted through contaminated blood contact, so avoidance of menstrual blood flow in the WSW partner whose hepatitis C status is unknown would be prudent. There is no vaccination against hepatitis C.

HIV/AIDS

There are few case reports of WSW transmission of HIV/AIDS. Infection may be transmitted via contact with infected bodily secretions (vaginal secretions), or blood (menstrual flow or other). Once again, prevention is key! Safe sex practices including the use of 100% latex barriers, whether dental dams for oral sex or condoms for insertive sexual toys are a proven method of decreasing the potential risk of HIV/AIDS transmissin/infection.