METHODS: This study investigated HIV testing history, sexual risk-taking behaviors, and perceptions of HIV-risk of a multi-ethnic sample of 239 self identified WSW aged 18-68 years (M=35.8 years, SD=12.2). Respondents completed an anonymous pen-and-paper questionnaire regarding their sexual practices, HIV testing behaviors, and perceptions of HIV-risk. The survey was offered in English and Spanish. Participants were recruited at lesbian, gay, bisexual, transgender (LGBT) pride events in three U.S. cities during the summer of 2010. The study used a cross sectional research design. Data were analyzed using Pearson's correlation analysis.
RESULTS: Seventy-five percent of the women self-identified as Black (63.9%) or non-white Hispanic (11.7%). While 18.2% had at least one male partner (reported sexual behaviors in the past 6 months), 19.6% “sometimes”, “rarely” or “never” told their women partners they have sex with men. One-third (33.5%) “never” or “rarely” practice safer sex. Of the women who engaged in sex during their partner's menstruation (27.6%), 45.3% reported coming into contact with the other woman's blood and 17.5% reported having vaginal contact with fingers/objects that have been in a rectum without cleaning them first. While most (68.2%) of the women believed that lesbians were at risk for contracting HIV, they did not think they were personally likely to get it. Sixty-two percent reported having oral/anal sex with a woman; 22% of those women reported using some type of protection (e.g., dental dam). Thirteen percent reported having oral/anal sex with men; 81% of those women reported using some type of protection. Correlation analysis showed that women who reported more male partners (r=.244, p<.01), who were not in a “primary” relationship with a woman (r=.185, p< .01), had shorter periods of time with their primary female partner (r=.191, p< .05), had sex with outside female partners (r=.169, p< .05), and were in a “primary” relationship with a man (r=.208; p< .01) reported feeling they were more likely to be at risk for acquiring HIV. Having sex with men was associated with more anal sex acts (r=.543; p< .05).
CONCLUSIONS AND IMPLICATIONS: Social workers who assume that their lesbian clients are not engaging in sex with men or other practices that place them at risk for HIV may be overlooking risk behaviors that may be more common than expected. Understanding sexual risk-taking in WSW may inform social work practice and influence policy, leading to the development of HIV educations and interventions to help prevent HIV acquisition among this understudied, overlooked group.
