Women who have sex with women

Current evidence indicates that women who have sex with women have the same rate of sexually transmitted infections (STIs) as heterosexual women, however the prevalence of particular STIs differs between these groups. Women who have sex with women should not be presumed to be at low or no risk for STIs based on sexual orientation
Few data are available on the risk for STIs transmitted by sex between women, but 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 toys; and oral-anal sex)
Women who have sex with women are at risk for acquiring bacterial, viral and protozoal infections from current and former partners, both male and female. Up to 90% of this group of women have had or continue to have male sexual partners
Prevalence of bacterial vaginosis (BV) is significantly higher for women who have sex with women (20-50%) than exclusively heterosexual women

Women who have sex with women are a diverse group with variations in sexual identity, sexual behaviours, sexual practices and risk behaviours. Testing of women who have sex with women will depend on the history, the clinical picture and risk factors identified
Routine cervical cancer screening should be offered to all women who have sex with women
Women who have sex with women should be offered the human papillomavirus (HPV) vaccine in accordance with current guidelines

Special considerations:

Women who have sex with women frequently have concordant vaginal microbiota with regular female partners, thought to be due to sexual behaviours which transfer vaginal secretions between them. It would be reasonable to suggest that regular female partners of women with BV are tested for BV, and treated if positive, although there is no evidence that this will reduce recurrences