Woman Have Sex

Woman Have Sex
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Diseases Characterized by Genital, Anal, or Perianal Ulcers
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WSW and WSWM comprise diverse groups with variations in sexual identity, practices, and risk behaviors. Studies indicate that certain WSW, particularly adolescents, young women, and WSWM, might be at increased risk for STIs and HIV on the basis of reported risk behaviors ( 275 – 280 ). Studies have highlighted the diversity of sexual practices and examined use of protective or risk-reduction strategies among WSW populations ( 281 – 283 ). Use of barrier protection with female partners (e.g., gloves during digital-genital sex, external condoms with sex toys, and latex or plastic barriers [also known as dental dams for oral-genital sex]) was infrequent in all studies. Although health organizations have online materials directed to patients, few comprehensive and reliable resources of sexual health information for WSW are available ( 284 ).
Recent studies regarding STI rates among WSW and WSWM indicate that WSWM experience higher rates of STIs than WSW, with rates comparable with women who have sex with men (WSM) in all studies reviewed ( 279 , 285 , 286 ). These studies indicate that WSW might experience STIs at lower rates than WSWM and WSM, although still at significant rates ( 287 ). One study reported higher sexual-risk behaviors among adolescent WSWM and WSW than among adolescent WSM ( 280 ). WSW report reduced knowledge of STI risks ( 288 ), and both WSW and WSWM experience barriers to care, especially Black WSW and WSWM ( 289 , 290 ). In addition, a continuum of sexual behaviors reported by WSW and WSWM indicates the need for providers to not assume lower risk for WSW, highlighting the importance of an open discussion about sexual health.
Few data are available regarding the risk for STIs conferred by sex between women; however, transmission risk probably varies by the specific STI and sexual practice (e.g., oral-genital sex; vaginal or anal sex using hands, fingers, or penetrative sex items; and oral-anal sex) ( 291 , 292 ). Practices involving digital-vaginal or digital-anal contact, particularly with shared penetrative sex items, present a possible means for transmission of infected cervicovaginal or anal secretions. This possibility is most directly supported by reports of shared trichomonas infections ( 293 , 294 ) and by concordant drug-resistance genotype testing and phylogenetic linkage analysis identifying HIV transmitted sexually between women ( 295 , 296 ). The majority of WSW (53%–97%) have had sex with men in the past and continue to do so, with 5%–28% of WSW reporting male partners during the previous year ( 292 , 297 – 300 ).
HPV can be transmitted through skin-to-skin contact, and sexual transmission of HPV likely occurs between WSW ( 301 – 303 ). HPV DNA has been detected through polymerase chain reaction (PCR)–based methods from the cervix, vagina, and vulva among 13%–30% of WSW ( 301 , 302 ) and can persist on fomites, including sex toys ( 304 ). Among WSW who report no lifetime history of sex with men, 26% had antibodies to HPV-16, and 42% had antibodies to HPV-6 ( 301 ). High-grade squamous intraepithelial lesions (HSIL) and low-grade squamous intraepithelial lesions (LSIL) have been detected on Papanicolaou smears (Pap tests) among WSW who reported no previous sex with men ( 301 , 302 ). WSWM are at risk for acquiring HPV from both their female partners and male partners and thus are at risk for cervical cancer. Therefore, routine cervical cancer screening should be offered to all women, regardless of sexual orientation or practices, and young adult WSW and WSWM should be offered HPV vaccination in accordance with recommendations ( 11 ) ( https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/hpv.html ).
Genital transmission of HSV-2 between female sex partners is inefficient but can occur. A U.S. population-based survey among women aged 18–59 years demonstrated an HSV-2 seroprevalence of 30% among women reporting same-sex partners during the previous year, 36% among women reporting same-sex partners in their lifetime, and 24% among women reporting no lifetime same-sex behavior ( 299 ). HSV-2 seroprevalence among women self-identifying as homosexual or lesbian was 8%, similar to a previous clinic-based study of WSW ( 299 , 305 ) but was 26% among Black WSW in one study ( 287 ). The relatively frequent practice of orogenital sex among WSW and WSWM might place them at higher risk for genital infection with HSV-1, a hypothesis supported by the recognized association between HSV-1 seropositivity and previous number of female partners. Thus, sexual transmission of HSV-1 and HSV-2 can occur between female sex partners. This information should be communicated to women as part of sexual health counseling.
Trichomonas is a relatively common infection among WSW and WSWM, with prevalence rates higher than for chlamydia or gonorrhea ( 306 , 307 ), and direct transmission of trichomonas between female partners has been demonstrated ( 293 , 294 ).
Limited information is available regarding transmission of bacterial STIs between female partners. Transmission of syphilis between female sex partners, probably through oral sex, has been reported. Although the rate of transmission of C. trachomatis or N. gonorrhoeae between women is unknown, infection also might be acquired from past or current male partners. Data indicate that C. trachomatis infection among WSW can occur ( 275 , 286 , 308 , 309 ). Data are limited regarding gonorrhea rates among WSW and WSWM ( 170 ). Reports of same-sex behavior among women should not deter providers from offering and providing screening for STIs, including chlamydia, according to guidelines.
BV is common among women, and even more so among women with female partners ( 310 – 312 ). Epidemiologic data strongly demonstrate that BV is sexually transmitted among women with female partners. Evidence continues to support the association of such sexual behaviors as having a new partner, having a partner with BV, having receptive oral sex, and having digital-vaginal and digital-anal sex with incident BV ( 313 , 314 ). A study including monogamous couples demonstrated that female sex partners frequently share identical genital Lactobacillus strains ( 315 ). Within a community-based cohort of WSW, extravaginal (i.e., oral and rectal) reservoirs of BV-associated bacteria were a risk factor for incident BV ( 316 ). Studies have examined the impact of specific sexual practices on the vaginal microflora ( 306 , 317 – 319 ) and on recurrent ( 320 ) or incident ( 321 , 322 ) BV among WSW. A BV pathogenesis study in WSW reported that Prevotella bivia, Gardnerella vaginalis , and Atopobium vaginae might have substantial roles in development of incident BV ( 323 ). These studies have continued to support, although have not proven, the hypothesis that sexual behaviors, specific BV-associated bacteria, and possibly exchange of vaginal or extravaginal microbiota (e.g., oral bacterial communities) between partners might be involved in the pathogenesis of BV among WSW.
Although BV is common among WSW, routine screening for asymptomatic BV is not recommended. Results of one randomized trial used a behavioral intervention to reduce persistent BV among WSW through reduced sharing of vaginal fluid on hands or sex toys. Women randomly assigned to the intervention were 50% less likely to report receptive digital-vaginal contact without gloves than control subjects, and they reported sharing sex toys infrequently. However, these women had no reduction in persistent BV at 1 month posttreatment and no reduction in incident episodes of recurrent BV ( 324 ). Trials have not been reported examining the benefits of treating female partners of women with BV. Recurrent BV among WSW is associated with having a same-sex partner and a lack of condom use ( 325 ). Increasing awareness of signs and symptoms of BV among women and encouraging healthy sexual practices (e.g., avoiding shared sex toys, cleaning shared sex toys, and using barriers) might benefit women and their partners.
Sexually active women are at risk for acquiring bacterial, viral, and protozoal STIs from current and previous partners, both male and female. WSW should not be presumed to be at low or no risk for STIs on the basis of their sexual orientation. Report of same-sex behavior among women should not deter providers from considering and performing screening for STIs and cervical cancer according to guidelines. Effective screening requires that care providers and their female patients engage in a comprehensive and open discussion of sexual and behavioral risks that extends beyond sexual identity.
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From Wikipedia, the free encyclopedia

^ Another summary of overall surveys found that women who identify as lesbian, 80-95% had previous sexual contact with men, and some report sexual behavior that is risky. (King, p. 221.)

^ Gorgos, L. M.; J. M. Marrazzo (2011). "Sexually Transmitted Infections Among Women Who Have Sex With Women" . Clinical Infectious Diseases . 53 (suppl 3): S84–S91. doi : 10.1093/cid/cir697 . ISSN 1058-4838 . PMID 22080273 .

^ King, p. 219.

^ Zimmerman, p. 359.

^ Jump up to: a b Gynaecology . Shaw, Robert W. (Robert Wayne), Luesley, David., Monga, Ash K. (4th ed.). Edinburgh: Churchill Livingstone/Elsevier. 2011. ISBN 9780702048388 . OCLC 787843377 . {{ cite book }} : CS1 maint: others ( link )

^ Vo, Christine, Carney, Michael (December 2007). "Ovarian Cancer Hormonal and Environmental Risk Effect", Obstetrics and Gynecology Clinics 34 (4) p. 687–700.

^ " Frequently Asked Questions: Lesbian Health Archived 2009-01-29 at the Wayback Machine ", womenshealth.gov. U.S. Department of Health and Human Services . Retrieved January 12, 2009.

^ Jump up to: a b Mravack, Sally A. (July 2006)."Primary Care for Lesbians and Bisexual Women", American Family Physician 74 (2), pp. 279–286.

^ "Special Populations - 2010 STD Treatment Guidelines" . CDC. Archived from the original on 2015-07-21 . Retrieved 2015-06-23 .

^ Frenkl, Tara Lee, Potts, Jeannette (February 2008). "Sexually Transmitted Infections", Urologic Clinics of North America , 35 (1) p. 33–46.

^ King, p. 226.

^ Marrazzo, Jeanne M.; Stine, Kathleen; Wald, Anna (2003). "Prevalence and risk factors for infection with herpes simplex virus type-1 and -2 among lesbians" . Sexually Transmitted Diseases . 30 (12): 890–895. doi : 10.1097/01.OLQ.0000091151.52656.E5 . PMID 14646636 . S2CID 22148830 . {{ cite journal }} : CS1 maint: url-status ( link )

^ Risser, Jan M.H., Risser, William L., Risser, Amanda (December 2008). "Epidemiology of Infections in Women", Infectious Disease Clinics of North America , 22 (4), pp. 581–599.

^ King, p. 229.

^ Zimmerman, 360.

^ HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States and Dependent Areas, 2006. Centers for Disease Control. Retrieved on January 9, 2009.

^ McNair, Ruth (2005). "Risks and prevention of sexually transmissible infections among women who have sex with women" . Sexual Health . 2 (4): 209–17. doi : 10.1071/sh04046 . ISSN 1448-5028 . PMID 16402667 .

^ Jump up to: a b c d Carroll, Janell L., author. (January 2018). Sexuality now : embracing diversity . ISBN 9781337404990 . OCLC 1064600804 . {{ cite book }} : |last= has generic name ( help ) CS1 maint: multiple names: authors list ( link )

^ Jump up to: a b Clarke, Victoria. (2010). Lesbian, Gay, Bisexual, Trans and Queer Psychology . Cambridge University Press. ISBN 9780521700184 . OCLC 1031490912 .

^ Clarke, Victoria; Ellis, Sonja J.; Peel, Elizabeth; Riggs, Damien W. (April 2010). Communicating Women's Health : social and cultural norms that influence health decisions . Madlock Gatison, Annette. New York. ISBN 978-0815386490 . OCLC 1004726096 .

^ Gatison, Annette Madlock (2015-12-07). Communicating Women's Health: Social and Cultural Norms that Influence Health Decisions . Routledge. ISBN 9781317553892 .

^ Jump up to: a b c "How to Use a Dental Dam | CDC" . www.cdc.gov . 2019-02-22 . Retrieved 2019-10-27 .

^ Enhanced Comprehensive HIV Prevention Planning and Implementation for Metropolitan Statistical Areas Most Affected by HIV/AIDS (ECHPP) for Houston-Baytown-Sugarland, Texas . Houston Department of Health and Human Services. 2011.

^ Jump up to: a b c d Richters, Juliet; Clayton, Stevie (2010). "The practical and symbolic purpose of dental dams in lesbian safer sex promotion" . Sexual Health . 7 (2): 103–6. doi : 10.1071/sh09073 . ISSN 1448-5028 . PMID 20648734 .

^ Richters, Juliet; Prestage, Garrett; Schneider, Karen; Clayton, Stevie (2010). "Do women use dental dams? Safer sex practices of lesbians and other women who have sex with women" . Sexual Health . 7 (2): 165–9. doi : 10.1071/sh09072 . ISSN 1448-5028 . PMID 20465981 .

^ Jump up to: a b c Stevens, Patricia E.; Hall, Joanne M. (July 2001). "Sexuality and Safer Sex: The Issues for Lesbians and Bisexual Women". Journal of Obstetric, Gynecologic & Neonatal Nursing . 30 (4): 439–447. doi : 10.1111/j.1552-6909.2001.tb01563.x . ISSN 0884-2175 . PMID 11461028 .

^ Jump up to: a b c d Lehmiller, Justin J. (2017-12-26). The psychology of human sexuality (Second ed.). Hoboken, NJ. ISBN 9781119164715 . OCLC 992433913 .

^ "Condom Fact Sheet for Public Health Personnel | CDC" . www.cdc.gov . 2019-04-18 . Retrieved 2019-10-31 .

^ Schlager, p. 152.

^ Jump up to: a b Schlager, p. 153.

^ Rust, Paula, (March, 1993). "Coming out" in the Age of Social Constructionism: Sexual Identity Formation among Lesbian and Bisexual Women", Gender and Society , 7 (1), p. 50-77.

^ Solarz, p. 69.

^ Schlager, pp. 157–158.

^ Solarz, p. 70.

^ Drabble, Laurie, Trocki, Karen (2005). "Alcohol Consumption, Alcohol-Related Problems, and Other Substance Use Among Lesbian and Bisexual Women", Journal of Lesbian Studies , 9 (3), p. 19–30.

^ Solarz, p. 81.

^ Jump up to: a b "NISVS: An Overview of 2010 Findings on Victimization by Sexual Orientation" (PDF) . CDC .

^ Jump up to: a b Badenes-Ribera, Laura; Bonilla-Campos, Amparo; Frias-Navarro, Dolores; Pons-Salvador, Gemma; Monterde-i-Bort, Hector (2015-05-27). "Intimate Partner Violence in Self-Identified Lesbians". Trauma, Violence, & Abuse . 17 (3): 284–297. doi : 10.1177/1524838015584363 . ISSN 1524-8380 . PMID 26018210 . S2CID 206737985 .

^ Johns, Michelle M.; Liddon, Nicole; Jayne, Paula E.; Beltran, Oscar; Steiner, Riley J.; Morris, Elana (January 2018). "Systematic Mapping of Relationship-Level Protective Factors and Sexual Health Outcomes Among Sexual Minority Youth: The Role of Peers, Parents, Partners, and Providers" . LGBT Health . 5 (1): 6–32. doi : 10.1089/lgbt.2017.0053 . ISSN 2325-8292 . PMC 5769143 . PMID 29271692 .

^ Mijas, Magdalena; Grabski, Bartosz; Blukacz, Mateusz; Davies, Dominic (2021-06-01). "Sexual Health Studies in Gay and Lesbian People: A Critical Review of the Literature" . The Journal of Sexual Medicine . 18 (6): 1012–1023. doi : 10.1016/j.jsxm.2021.02.013 . ISSN 1743-6095 . PMID 33947648 . S2CID 233742279 .

Wikimedia Commons has media related to Gay sex .
Women who have sex with women ( WSW ) are women who engage in sexual activities with other women, whether they identify themselves as lesbian , bisexual , or heterosexual , or dispense with sexual identification altogether. [1] The term WSW is often used in medical literature to describe such women as a group for clinical study, without needing to consider sexual self-identity.

In terms of medical issues with regard to lesbian sexual practices , the sexual identification of women who consult a medical professional is usually not sought nor volunteered, due to the misconceptions and assumptions about sexuality and the hesitancy of some women in disclosing their accurate sexual histories even to a physician. [2] Lack of differentiation between lesbians and heterosexual women in medical studies that concentrate on health issues for women skews results for lesbians and non-lesbian women. Many women who do not participate in heterosexual activity do not go to see a physician because they do not require birth control , which is the initiating factor for most women to seek consultation with a gynecologist when they become sexually active. [3] As a result, these women are not screened regularly with pap smears because they have a lower perceived risk of acquiring a sexually transmitted infection or types of cancer. Lesbians are less likely than their heterosexual and bisexual counterparts to get screened for cervical cancer , with some being refuse
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