Use of barrier protection for sexual activity in women who have sex with women

Introduction: Women who have sex with women (WSW) are generally regarded as having lower risk for sexually transmitted infections (STI) compared to other groups. However, recent studies show this population may be at increased risk for STIs. Methods: We performed an internet-based cross sectional study of sexual practices in WSW. Information was gathered on frequency of use of barrier methods for STI prevention in the context of various sexual activities. Data were gathered on demographics, health status, and sexual practices. Results: 1,557 respondents had complete data for the outcomes of interest. 1,233 respondents were in relationships, 1016 of which were monogamous. 305 women reported sex with women they did not know well and 136 with men they did not know well. 181 (12%) women reported more than one partner and variable or no use of barriers. Approximately 87% of respondents never used barriers for giving or receiving digital and oral sex. Barriers were “never” used when giving or receiving genital stimulation with a toy in 62% and 62% of respondents. Barriers were less likely to be used by women with one partner compared those with multiple partners (OR 0.3, CI 0.1-0.98). On multivariate analysis, no demographic, health, or relationship variables were clearly and significantly associated with likelihood of barrier use. Conclusions: A high percentage of WSW in this survey do not consistently use barriers, irrespective of relationship status and partner variables. Increased attention to safer sex education in WSW is warranted at the provider and policy levels.