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West J Med. 2000 Jun;172(6):379-84.

Use of preventive health behaviors by lesbian, bisexual, and heterosexual women: questionnaire survey.

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  • 1Department of Obstetrics and Gynecology, California Pacific Medical Center, San Francisco 94118, USA.



To determine whether lesbians and bisexual women are less likely than heterosexual women to use preventive health measures.


Written, anonymous, self-administered questionnaire.


33 physicians' offices and community clinics mainly in urban areas of 13 states.


524 lesbians, 143 bisexual women, and 637 heterosexual women.


Bisexual women were less likely than heterosexual women to have had appropriate cholesterol screening (odds ratio 0.29, 95% confidence interval 0.11 to 0.73) or appropriate mammography (0.33, 0.13 to 0.84). Human immunodeficiency virus testing was more common in lesbians (2.38, 1. 51 to 3.74) and bisexual women (1.99, 1.17 to 3.38) than in heterosexual women. Illicit drug use was higher in lesbians (2.04, 1. 14 to 3.70) and bisexual women (1.96, 1.07 to 3.57) than in heterosexual women. Lesbians were more likely than heterosexual women to practice safer sex (2.60, 1.23 to 5.49) and less likely to have ever been infected with human papillomavirus (0.48, 0.25 to 0. 89).


There were important differences in the preventive health measures taken by lesbians and bisexual women and those taken by heterosexual women. All patients should receive standard health tests, such as cholesterol screening and mammography, regardless of their sexual orientation. Lesbians and bisexual women who report illicit drug use should receive counseling, as appropriate.

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