Updated: March 1, 2007
Certain high risk Human Papillomaviruses (HPVs) are sexually transmitted infections which can lead to a number of anogenital cancers, including cervical cancer. The recommendation that all females from 11 to 26 years of age be immunized with HPV vaccine was an important public health milestone.
An important—and often overlooked—group of women who should also get this vaccine are women who have sex with other women.
Women who have sex with women (WSW). WSW may comprise as many as 4.5% of sexually active women in the US who are 18-45 years of age.1 However, 43% of WSW identify themselves as heterosexual, 39% as lesbian and 18% as bisexual.1
The majority of WSW do not inform their health provider of their sexual activity with women2, they are less likely to have a health provider1 and they are less likely to utilize preventive health services—such as Pap screening and mammograms.13
About 80% WSW have also previously had sex with men. 245 As a consequence, these women are at the same risk (or higher) of acquiring sexually transmitted infections than exclusively heterosexual women, including HPV.
Approximately 20% of WSW have had sex exclusively with other women. 234 A common misperception is that these women are not at risk of acquiring infection with high risk strains of HPV. Although the risk of acquiring HPV infection in these women may be a bit lower than in exclusively heterosexual women36,
Barriers to preventive healthcare (including Pap screening and HPV vaccine) for those women who have sex exclusively with other women. Perhaps the greatest barrier may be the widespread belief by both these women and their health providers that women who exclusively have sex with women are not at risk of HPV—and therefore, cervical cancer—because they have not been sexually active with men.1234
A number of factors have been identified for why lesbian and bisexual women are an underserved population for preventive health care.