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Sex Transm Dis. 2005 Sep;32(9):563-9.

Sexual risk factors among self-identified lesbians, bisexual women, and heterosexual women accessing primary care settings.

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  • 1Department of Obstetrics and Gynecology, California Pacific Medical Center, San Francisco, CA 94115, USA.



There is scant data on the sexual behaviors of women of diverse sexual orientations in a low-risk population.


The goals of this study were to sample women of all sexual orientations in primary care settings and to evaluate sexual behaviors and risk for HIV and other sexually transmitted diseases (STDs).


A total of 1,304 women (self-identified as 49% heterosexual, 11% bisexual, and 40% lesbian) were surveyed by anonymous questionnaire at 33 healthcare sites.


Among women who recently had sex with men (N = 600), 51% reported ever using condoms. Heterosexual women were at highest risk for acquiring HIV as a result of lack of condom use (P <0.001), particularly in higher-risk situations. Bisexual women reported substance use with sex at a higher rate than lesbians or heterosexual women (P <0.001). Lesbians had higher rates of sex with bisexual men (P <0.001) and injection drug users (P <0.02), but also a higher rate of condom use (P <0.001) compared with bisexual or heterosexual women.


Women of all sexual orientations, and particularly heterosexual women, engaged in behaviors that put them at risk for HIV and STD.

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