Bisexual, lesbian women less likely to get pap tests

A new study finds that young bisexual and lesbian women are less likely to get Pap tests than straight women, while young bisexual women face a higher risk of being diagnosed with sexually transmitted diseases.

The findings about Pap tests suggest that young lesbian and bisexual women are not monitoring their sexual health as much as their heterosexual counterparts and could be at risk of developing cervical cancer. These women “report having sex at a younger age and with more people,” said lead study author Brittany Charlton, a graduate student in epidemiology at the Harvard School of Public Health. “That could certainly put them at risk. It’s really important that they be screened.”

The study authors examined the results of surveys done in 2005 of 4,224 females ages 17 to 25. Ninety-three percent were white; all but 9 percent had been sexually active.

Lesbians, who made up abouut 1 percent of the women surveyed, were less likely to have gotten a Pap test, which detects the presence of a sexually transmitted virus that can cause cervical cancer and other medical problems. In the previous year, 70 percent had undergone screening, compared with 88 percent of heterosexual women.

Twenty-two percent of bisexual women said they had a previous diagnosis of a sexually transmitted disease, in comparison with 11 percent of those who were heterosexual and 8 percent of lesbians.

The study appears online in the Journal of Adolescent Health.

Women who have sex with other women are at lower risk of getting sexually transmitted diseases than are women who have sex with men, although some of the diseases can spread between women. There is a complicating factor to this picture: Young women who are not heterosexual most likely have still had sex with men at some point in their lives. Research suggests that about three-quarters of sexually active lesbian adolescents have had sex with men; the number is 96 percent among bisexuals.

Why might bisexual and lesbian young women go without Pap tests? “Many may not believe they’re at risk of catching a sexually transmitted infection or even needing to have a Pap smear,” Charlton said. She added that gay men, bisexuals and lesbians could feel uncomfortable talking to doctors about their sexual orientation and sex lives.

Susan Cochran, a professor of epidemiology at UCLA who studies sexual orientation and health, said, “young lesbians aren’t any more averse to getting good health care than anyone else. Health care for young women is organized around reproductive assumptions. Young women seek gynecologic care primarily to obtain birth control. If they don’t believe they need birth control, then one push toward getting care is removed.”

In fact, research has shown that women are at risk of transmitting human papillomavirus − which can cause cervical cancer − to each other through sex, said Devika Singh, M.D., a fellow at the University of Washington who has done research on lesbian health. “There continues to be a lack of general awareness on the part of many health care providers on what defines sex between women and what risks may be associated with sexual practices between women,” Singh said.

“Regardless of their sexual orientation, women need to find a doctor or nurse practitioner they trust and get checked,” Charlton said. “That’s important to their life overall. And medical professionals need to be sure to screen all their patients regardless of their sexual orientation.”