University of Sydney study finds that lesbian women are being tested less for virus that can cause cervical cancer and sexually transmitted disease in general
Study co-author Dr Julie Mooney summers said the mistaken belief that, if women didn’t have sex with men, they did not need pap smears was a ‘real frustration’. Photograph: Voisin/Phanie/Rex Shutterstock
An “urban myth” that lesbian women do not need pap smears because they do not have sex with men means they are putting their health at risk, a study from the University of Sydney has found.
Researchers said lesbian women also generally tested less often for sexually transmitted infections than bisexual or queer women.
They said the findings highlighted the importance of targeting health campaigns to specific groups within the lesbian, gay, bisexual, transgender and queer [LGBTQ] community, rather than to that community as a whole.
Researchers analysed data from a survey of 379 women aged between 17 and 30 taken during the Sydney Gay and Lesbian Mardi Gras in 2010 and 2012. The survey, which asks lesbian, bisexual and queer women about their health, sexual identity, sexual relationships and sexual practices, has been conducted every two years since 1996.
While queer women – those who did not identify as lesbian or bisexual in the survey – had the highest rates of illicit drug use, experiences of sexual coercion, and anti-LGBTQ discrimination, they were the group most proactive about their health, the researchers found.
While 58.3% of bisexual women reported being tested for sexually transmitted infections at least once, only 52.9% of lesbian women reported the same, the lowest of the three groups.
Only 65.2% of lesbian women had ever received a pap smear, compared with 70.8% of bisexual women and 79.4% of queer women, the study, led by Rada Germanos from the University of Sydney’s school of medicine and published in the journal, LGBT health, also found.
Pap smears are used to detect cervical cancer, spread by the human papillomavirus (HPV). There are more than 100 different types of HPV and some types, if left untreated, can cause cervical cancer. Most people with HPV don’t have symptoms and while the virus can go away on its own, it can persist and cause harm.
While women most commonly acquire HPV through sex with a man, it can can also be transmitted through genital skin-to-skin contact, or sex toys, making pap smears important for LGBTQ women as well.
Dr Julie Mooney-Somers, one of the authors of the study and a lecturer at the University of Sydney, said almost 60% of lesbian women surveyed had a history of sex with men, which was another reason they should be tested.
“It’s become a bit of an urban myth that women who don’t have sex with men don’t need pap smears, and this is one of the real frustrations about working in this area,” she said.
“Lesbian women also don’t usually need access to contraception so they’re not having those opportunistic discussions with their doctors about screening.”
LGBTQ women were also at higher risk of other cancers, such as lung cancer, due to more prevalent use of tobacco, alcohol and illicit drugs, she said. But the impact of cervical cancer on this group was largely unknown, Mooney-Somers said, because women with cervical cancer were not necessarily asked about their sexual identity.
“The main message is that while we may be doing well around pap smears in general, some women are being left behind,” she said.
“We need to pay attention to them and the reasons behind why they’re not engaging and how we can better target them. Lesbian women may not relate to sexual health campaigns targeting LGBTQ people generally, just like we know some people with problem drinking may not think alcohol campaigns are talking about them.”
Hiranthi Perera, the manager of PapScreen Victoria, has conducted a survey of lesbian, gay, bisexual, transgender and intersex people to analyse cervical screening behaviours.
While the results are still being analysed and are yet to be published, Perera said the aim would be to improve screening services.
“A common misconception is that this group don’t need cervical screening,” Perera said.
“This isn’t the case, as any person with a cervix who participates in any genital-skin to genital-skin contact, needs to have a pap test.”