Roughly three-quarters of lesbians who responded to a magazine survey have had sexual intercourse with men, and nearly two-thirds have had unprotected heterosexual intercourse. One-sixth of respondents have ever had anal intercourse with a male partner, and the same proportion have ever had a sexually transmitted disease STD. Researchers analyzing the survey point out that clinicians should be aware of the need to take a full sexual history of their lesbian patients, so opportunities to refer women for needed Pap smears or STD screening will not be missed.
The data come from responses to a item questionnaire that was included as an insert in the March issue of The Advocate, a national newsmagazine for gay, lesbian and bisexual men and women. The sample of 6, self-identified lesbians who returned the questionnaire responded to items asking about their sexual experience with men and about their history of STD testing and diagnosis.
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Respondents were also asked to provide information on their social and demographic characteristics, including race or ethnicity, age, annual income, educational attainment and population size of their community. Researchers performed multivariate logistic regression analyses with the variables that proved ificant in bivariate analyses to determine which factors independently affected women's likelihood of ever having had vaginal intercourse, of having had sexual intercourse without a condom and of having had a male sexual partner in the year.
Six percent of the sample had had sex with a male partner in the past year. Nevertheless, among those who had engaged in unprotected anal or vaginal sex, two-fifths had never had an HIV test. In the multivariate analyses, the variables that independently raised lesbians' likelihood of having had a male sexual partner within the past year were young age, low income, nonwhite race and not having graduated from college. For example, respondents younger than 25 were 6.
Advocate readers who had not graduated from college were ificantly more likely than those with a postgraduate degree to have ever had heterosexual intercourse odds ratio, 1. Lesbians younger than 50 were ificantly less likely than older women to have done so 0.
Among respondents with a history of vaginal intercourse, women younger than 25 were substantially less likely than those older than 50 to have ever had heterosexual intercourse without a condom odds ratio, 0. Respondents who had not graduated from college had slightly elevated odds of having had penile-vaginal intercourse without a condom 1. This analysis also took into the of male partners a woman had had, and the are dramatic.
Compared with respondents who had had sex with only one man, those who had had male partners were 2. The researchers affirm that because the study did not use probability sampling, its generalizability to all U. What is more, they acknowledge that respondents to sex surveys tend to hold more liberal sexual attitudes and be more sexually active than those who choose not to respond; this sample of magazine readers was also relatively affluent and well educated.
According to the researchers, however, the magazine-insert approach improved on efforts to ascertain levels of sexual activity among U. The data reveal that substantial proportions of lesbians have engaged in sexual activity with men, which places them at risk for a range of STDs and for cervical cancer. Therefore, the researchers assert that if clinicians automatically assume that lesbians have had no sexual contact with men, these health professionals might miss opportunities to give appropriate advice or recommendations to patients in their care.
They conclude that "it is important for the clinician to know a patient's complete medical and social history, including current and past sexual activity, to make appropriate decisions regarding the provision of appropriate health care.
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Perspectives on Sexual and Reproductive Health A journal of peer-reviewed research. Disclaimer The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.
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