Women who have sex with other women are a group that has been mostly invisible from public health policies. This category includes the group of lesbians, bisexual women, heterosexual behaviour, and homosexual practices, who have sexual relations with transsexual and transgender (trans) women and trans men who have sex with women. In the absence of a Spanish literature review of a study that addresses women who have sex with other women, a narrative bibliographic review was done using the PubMed/MEDLINE, Scopus, Dialnet, and Taylor and Francis databases. From a universe of 679 articles and after applying the inclusion criteria, 40 documents were analysed, from 1998 to 2019. Three meta-categories were identified (sexual education, the incidence of certain sexually transmitted infections, and aspects related to sexual practices), concerning prevention and risky behaviours. Women who have sex with other women are a particularly vulnerable group when it comes to sexually transmitted infections. These may include bacterial vaginitis, human papillomavirus and acquired immunodeficiency virus. Likewise, there is a lack of specific training and information in health and education professionals, as well as in women who have sex with other women.

Affiliation:
[1] Facultad de Trabajo Social y Desarrollo Humano, Universidad Autónoma de Nuevo León, Nuevo León, México

E-mail: luismaotero@yahoo.es

Author address:
[1] Miguel de Cervantes Saavedra 380
Irrigación, Ciudad de México
México.

Citation: Rodríguez-Otero LM. Literature review on studies of women who have sex with women. Medwave 2020;20(3):e7884 doi: 10.5867/medwave.2020.03.7884

Submission date: 5/11/2019

Acceptance date: 27/3/2020

Publication date: 17/4/2020

Origin: Not commissioned.

Type of review: Externally peer-reviewed by two reviewers, double-blind.

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1. Lameiras M, Carrera M, Rodríguez Y. Sexualidad y salud. El estudio de la sexualidad humana desde una perspectiva de género. Vigo: Universidade de Vigo. 2013.
2. Solana M. El debate sobre los orígenes de la homosexualidad masculina. Una revisión de la distinción entre esencialismo y construccionismo en historia de la sexualidad. Tópicos, Revista de Filosofía. 2018; 1(54): 395-427. | CrossRef |
3. Langarita JA. Diversidad sexo-genética y trabajo social: miradas, preguntas y retos. RTS. 2016; (208): 9-18. [Internet] | Link |
4. Hernández R, Caudillo L, Flores M. Efectos del consumo de alcohol y homofobia internalizada en la conducta sexual en hombres que tienen sexo con hombres. Jóvenes en la Ciencia; 2018 3(1): 373-376. [Internet] | Link |
5. Plazas A. Hombres que tienen sexo con hombres. Desde su realidad en Santiago de Cali. XIV Congreso Colombiano de Sexología y Educación Sexual. Medellín: Sociedad Colombiana de Sexología. 2009. [Internet] | Link |
6. Knight D, Jarrett D. Preventive Health Care for Women Who Have Sex with Women. American Family Physician; 2017, 95(5): 314-321. [Internet] | Link |
7. Evans MG, Cloete A, Zungu N, Simbayi LC. HIV Risk Among Men Who Have Sex With Men, Women Who Have Sex With Women, Lesbian, Gay, Bisexual and Transgender Populations in South Africa: A Mini-Review. Open AIDS J. 2016 Apr 8;10:49-64. | CrossRef | PubMed |
8. Tat SA, Marrazzo JM, Graham SM. Women Who Have Sex with Women Living in Low- and Middle-Income Countries: A Systematic Review of Sexual Health and Risk Behaviors. LGBT Health. 2015 Jun;2(2):91-104. | CrossRef | PubMed |
9. Forcey DS, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, et al. Factors Associated with Bacterial Vaginosis among Women Who Have Sex with Women: A Systematic Review. PLoS One. 2015 Dec 16;10(12):e0141905. | CrossRef | PubMed |
10. Franco JVA, Arancibia M, Simancas-Racines D, Madrid E. Syntheses of biomedical information: narrative reviews, systematic reviews and emerging formats. Medwave. 2018 Nov 27;18(7):e7354. | CrossRef | PubMed |
11. Rufino AC, Madeiro A, Trinidad A, Santos R, Freitas I. Sexual practices and health care of women who have sex with women: 2013-2014. Epidemiol Serv Saude. 2018 Nov 8;27(4):e2017499. | CrossRef | PubMed |
12. Burkill S, Waterhouse P. Sources of Sex Information Used by Young British Women Who Have Sex with Women (WSW) and Women Who. Sexuality Research and Social Polic; 2019 16(1): 22-30. | CrossRef |
13. Grabski B, Dora M, Iniewicz G, Mijas M, Müldner-Nieckowski Ł. The character of sexual function of women who have sex with women. Psychiatr Pol. 2018 Dec 29;52(6):1075-1085. | CrossRef | PubMed |
14. Silberman P, Buedo PE, Burgos LM. [Barriers to sexual health care in Argentina: perception of women who have sex with women]. Rev Salud Publica (Bogota). 2016 Feb;18(1):1-12. | CrossRef | PubMed |
15. Richters J, Prestage G, Schneider K, Clayton S. Do women use dental dams? Safer sex practices of lesbians and other women who have sex with women. Sex Health. 2010 Jun;7(2):165-9. | CrossRef | PubMed |
16. Marrazzo JM, Koutsky LA, Eschenbach DA, Agnew K, Stine K, Hillier SL. Characterization of vaginal flora and bacterial vaginosis in women who have sex with women. J Infect Dis. 2002 May 1;185(9):1307-13. | PubMed |
17. Ignacio MAO, Andrade J, Freitas APF, Pinto GVDS, Silva MGD, Duarte MTC. Prevalence of bacterial vaginosis and factors associated among women who have sex with women. Rev Lat Am Enfermagem. 2018 Nov 14;26:e3077. | CrossRef | PubMed |
18. Marrazzo JM, Thomas KK, Agnew K, Ringwood K. Prevalence and risks for bacterial vaginosis in women who have sex with women. Sex Transm Dis. 2010 May;37(5):335-9. | PubMed |
19. Alexander KA, Fannin EF. Sexual safety and sexual security among young Black women who have sex with women and men. J Obstet Gynecol Neonatal Nurs. 2014 Jul-Aug;43(4):509-19. | CrossRef | PubMed |
20. Bradshaw CS, Walker SM, Vodstrcil LA, Bilardi JE, Law M, Hocking JS, et al. The influence of behaviors and relationships on the vaginal microbiota of women and their female partners: the WOW Health Study. J Infect Dis. 2014 May 15;209(10):1562-72. | CrossRef | PubMed |
21. Rowen TS, Breyer BN, Lin TC, Li CS, Robertson PA, Shindel AW. Use of barrier protection for sexual activity among women who have sex with women. Int J Gynaecol Obstet. 2013 Jan;120(1):42-5. | CrossRef |
22. Shindel AW, Rowen TS, Lin TC, Li CS, Robertson PA, Breyer BN. An Internet survey of demographic and health factors associated with risk of sexual dysfunction in women who have sex with women. J Sex Med. 2012 May;9(5):1261-71. | CrossRef | PubMed |
23. Brenick A, Romano K, Kegler C, Eaton LA. Understanding the Influence of Stigma and Medical Mistrust on Engagement in Routine Healthcare Among Black Women Who Have Sex with Women. LGBT Health. 2017 Feb;4(1):4-10. | CrossRef | PubMed |
24. Poteat TC, Logie CH, Adams D, Mothopeng T, Lebona J, Letsie P, et al. Stigma, sexual health, and human rights among women who have sex with women in Lesotho. Reprod Health Matters. 2015 Nov;23(46):107-16. | CrossRef | PubMed |
25. Barbosa RM, Facchini R. [Access to sexual health care for women who have sex with women in São Paulo, Brazil]. Cad Saude Publica. 2009;25 Suppl 2:S291-300. | PubMed |
26. Zaidi SS, Ocholla AM, Otieno RA, Sandfort TG. Women Who Have Sex with Women in Kenya and Their Sexual and Reproductive Health. LGBT Health. 2016 Apr;3(2):139-45. | CrossRef | PubMed |
27. Bauer GR, Welles SL. Beyond assumptions of negligible risk: sexually transmitted diseases and women who have sex with women. Am J Public Health. 2001 Aug;91(8):1282-6. | PubMed |
28. Bailey JV, Farquhar C, Owen C, Mangtani P. Sexually transmitted infections in women who have sex with women. Sex Transm Infect. 2004 Jun;80(3):244-6. | PubMed |
29. Fethers K, Marks C, Mindel A, Estcourt CS. Sexually transmitted infections and risk behaviours in women who have sex with women. Sex Transm Infect. 2000 Oct;76(5):345-9. | PubMed |
30. Reisner SL, Mimiaga MJ, Case P, Grasso C, O'Brien CT, Harigopal P, et al. Sexually transmitted disease (STD) diagnoses and mental health disparities among women who have sex with women screened at an urban community health center, Boston, MA, 2007. Sex Transm Dis. 2010 Jan;37(1):5-12. | CrossRef | PubMed |
31. Muzny CA, Pérez AE, Eaton EF, Agénor M. Psychosocial Stressors and Sexual Health Among Southern African American Women Who Have Sex with Women. LGBT Health. 2018 May/Jun;5(4):234-241. | CrossRef | PubMed |
32. Logie CH, Navia D, Rwigema MJ, Tharao W, Este D, Loutfy MR. A group-based HIV and sexually transmitted infections prevention intervention for lesbian, bisexual, queer and other women who have sex with women in Calgary and Toronto, Canada: study protocol for a non-randomised cohort pilot study. BMJ Open. 2014 Apr 23;4(4):e005190. | CrossRef | PubMed |
33. Wang X, Norris JL, Liu Y, Vermund SH, Qian HZ, Han L, et al. Risk behaviors for reproductive tract infection in women who have sex with women in Beijing, China. PLoS One. 2012;7(7):e40114. | CrossRef | PubMed |
34. McNair R. Risks and prevention of sexually transmissible infections among women who have sex with women. Sex Health. 2005;2(4):209-17. | PubMed |
35. Massad LS, Xie X, Minkoff H, Darragh TM, D'Souza G, Sanchez-Keeland L, et al. Abnormal pap tests and human papillomavirus infections among HIV-infected and uninfected women who have sex with women. J Low Genit Tract Dis. 2014 Jan;18(1):50-6. | CrossRef | PubMed |
36. Kerker BD, Mostashari F, Thorpe L. Health care access and utilization among women who have sex with women: sexual behavior and identity. J Urban Health. 2006 Sep;83(5):970-9. | PubMed |
37. Marrazzo JM, Koutsky LA, Kiviat NB, Kuypers JM, Stine K. Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women. Am J Public Health. 2001 Jun;91(6):947-52. | PubMed |
38. Marrazzo JM, Koutsky LA, Stine KL, Kuypers JM, Grubert TA, Galloway DA, Kiviat NB, et al. Genital human papillomavirus infection in women who have sex with women. J Infect Dis. 1998 Dec;178(6):1604-9. | PubMed |
39. Vodstrcil LA, Walker SM, Hocking JS, Law M, Forcey DS, Fehler G, et al. Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clin Infect Dis. 2015 Apr 1;60(7):1042-53. | CrossRef | PubMed |
40. Sturm RM, Breyer BN, Li CS, Subak LL, Brown JS, Shindel AW. Prevalence of overactive bladder and stress urinary incontinence in women who have sex with women: an internet-based survey. J Womens Health (Larchmt). 2014 Nov;23(11):935-40. | CrossRef | PubMed |
41. Marrazzo JM, Thomas KK, Fiedler TL, Ringwood K, Fredricks DN. Relationship of specific vaginal bacteria and bacterial vaginosis treatment failure in women who have sex with women. Ann Intern Med. 2008 Jul 1;149(1):20-8. | PubMed |
42. Gorgos LM, Marrazzo JM. Sexually transmitted infections among women who have sex with women. Clin Infect Dis. 2011 Dec;53 Suppl 3:S84-91. | CrossRef | PubMed |
43. Marrazzo JM, Thomas KK, Fiedler TL, Ringwood K, Fredricks DN. Risks for acquisition of bacterial vaginosis among women who report sex with women: a cohort study. PLoS One. 2010 Jun 15;5(6):e11139. | CrossRef | PubMed |
44. Forcey DS, Walker SM, Vodstrcil LA, Fairley CK, Bilardi JE, Law M, et al. Factors associated with participation and attrition in a longitudinal study of bacterial vaginosis in Australian women who have sex with women. PLoS One. 2014 Nov 20;9(11):e113452. | CrossRef | PubMed |
45. Barbosa RM, Koyama MA. [Women who have sex with women: estimates for Brazil]. Cad Saude Publica. 2006 Jul;22(7):1511-4. | PubMed |
46. Bell AV, Ompad D, Sherman SG. Sexual and drug risk behaviors among women who have sex with women. Am J Public Health. 2006 Jun;96(6):1066-72. | PubMed |

Lameiras M, Carrera M, Rodríguez Y. Sexualidad y salud. El estudio de la sexualidad humana desde una perspectiva de género. Vigo: Universidade de Vigo. 2013.

Solana M. El debate sobre los orígenes de la homosexualidad masculina. Una revisión de la distinción entre esencialismo y construccionismo en historia de la sexualidad. Tópicos, Revista de Filosofía. 2018; 1(54): 395-427. | CrossRef |

Langarita JA. Diversidad sexo-genética y trabajo social: miradas, preguntas y retos. RTS. 2016; (208): 9-18. [Internet] | Link |

Hernández R, Caudillo L, Flores M. Efectos del consumo de alcohol y homofobia internalizada en la conducta sexual en hombres que tienen sexo con hombres. Jóvenes en la Ciencia; 2018 3(1): 373-376. [Internet] | Link |

Plazas A. Hombres que tienen sexo con hombres. Desde su realidad en Santiago de Cali. XIV Congreso Colombiano de Sexología y Educación Sexual. Medellín: Sociedad Colombiana de Sexología. 2009. [Internet] | Link |

Knight D, Jarrett D. Preventive Health Care for Women Who Have Sex with Women. American Family Physician; 2017, 95(5): 314-321. [Internet] | Link |

Evans MG, Cloete A, Zungu N, Simbayi LC. HIV Risk Among Men Who Have Sex With Men, Women Who Have Sex With Women, Lesbian, Gay, Bisexual and Transgender Populations in South Africa: A Mini-Review. Open AIDS J. 2016 Apr 8;10:49-64. | CrossRef | PubMed |

Tat SA, Marrazzo JM, Graham SM. Women Who Have Sex with Women Living in Low- and Middle-Income Countries: A Systematic Review of Sexual Health and Risk Behaviors. LGBT Health. 2015 Jun;2(2):91-104. | CrossRef | PubMed |

Forcey DS, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, et al. Factors Associated with Bacterial Vaginosis among Women Who Have Sex with Women: A Systematic Review. PLoS One. 2015 Dec 16;10(12):e0141905. | CrossRef | PubMed |

Franco JVA, Arancibia M, Simancas-Racines D, Madrid E. Syntheses of biomedical information: narrative reviews, systematic reviews and emerging formats. Medwave. 2018 Nov 27;18(7):e7354. | CrossRef | PubMed |

Rufino AC, Madeiro A, Trinidad A, Santos R, Freitas I. Sexual practices and health care of women who have sex with women: 2013-2014. Epidemiol Serv Saude. 2018 Nov 8;27(4):e2017499. | CrossRef | PubMed |

Burkill S, Waterhouse P. Sources of Sex Information Used by Young British Women Who Have Sex with Women (WSW) and Women Who. Sexuality Research and Social Polic; 2019 16(1): 22-30. | CrossRef |

Grabski B, Dora M, Iniewicz G, Mijas M, Müldner-Nieckowski Ł. The character of sexual function of women who have sex with women. Psychiatr Pol. 2018 Dec 29;52(6):1075-1085. | CrossRef | PubMed |

Silberman P, Buedo PE, Burgos LM. [Barriers to sexual health care in Argentina: perception of women who have sex with women]. Rev Salud Publica (Bogota). 2016 Feb;18(1):1-12. | CrossRef | PubMed |

Richters J, Prestage G, Schneider K, Clayton S. Do women use dental dams? Safer sex practices of lesbians and other women who have sex with women. Sex Health. 2010 Jun;7(2):165-9. | CrossRef | PubMed |

Marrazzo JM, Koutsky LA, Eschenbach DA, Agnew K, Stine K, Hillier SL. Characterization of vaginal flora and bacterial vaginosis in women who have sex with women. J Infect Dis. 2002 May 1;185(9):1307-13. | PubMed |

Ignacio MAO, Andrade J, Freitas APF, Pinto GVDS, Silva MGD, Duarte MTC. Prevalence of bacterial vaginosis and factors associated among women who have sex with women. Rev Lat Am Enfermagem. 2018 Nov 14;26:e3077. | CrossRef | PubMed |

Marrazzo JM, Thomas KK, Agnew K, Ringwood K. Prevalence and risks for bacterial vaginosis in women who have sex with women. Sex Transm Dis. 2010 May;37(5):335-9. | PubMed |

Alexander KA, Fannin EF. Sexual safety and sexual security among young Black women who have sex with women and men. J Obstet Gynecol Neonatal Nurs. 2014 Jul-Aug;43(4):509-19. | CrossRef | PubMed |

Bradshaw CS, Walker SM, Vodstrcil LA, Bilardi JE, Law M, Hocking JS, et al. The influence of behaviors and relationships on the vaginal microbiota of women and their female partners: the WOW Health Study. J Infect Dis. 2014 May 15;209(10):1562-72. | CrossRef | PubMed |

Rowen TS, Breyer BN, Lin TC, Li CS, Robertson PA, Shindel AW. Use of barrier protection for sexual activity among women who have sex with women. Int J Gynaecol Obstet. 2013 Jan;120(1):42-5. | CrossRef |

Shindel AW, Rowen TS, Lin TC, Li CS, Robertson PA, Breyer BN. An Internet survey of demographic and health factors associated with risk of sexual dysfunction in women who have sex with women. J Sex Med. 2012 May;9(5):1261-71. | CrossRef | PubMed |

Brenick A, Romano K, Kegler C, Eaton LA. Understanding the Influence of Stigma and Medical Mistrust on Engagement in Routine Healthcare Among Black Women Who Have Sex with Women. LGBT Health. 2017 Feb;4(1):4-10. | CrossRef | PubMed |

Poteat TC, Logie CH, Adams D, Mothopeng T, Lebona J, Letsie P, et al. Stigma, sexual health, and human rights among women who have sex with women in Lesotho. Reprod Health Matters. 2015 Nov;23(46):107-16. | CrossRef | PubMed |

Barbosa RM, Facchini R. [Access to sexual health care for women who have sex with women in São Paulo, Brazil]. Cad Saude Publica. 2009;25 Suppl 2:S291-300. | PubMed |

Zaidi SS, Ocholla AM, Otieno RA, Sandfort TG. Women Who Have Sex with Women in Kenya and Their Sexual and Reproductive Health. LGBT Health. 2016 Apr;3(2):139-45. | CrossRef | PubMed |

Bauer GR, Welles SL. Beyond assumptions of negligible risk: sexually transmitted diseases and women who have sex with women. Am J Public Health. 2001 Aug;91(8):1282-6. | PubMed |

Bailey JV, Farquhar C, Owen C, Mangtani P. Sexually transmitted infections in women who have sex with women. Sex Transm Infect. 2004 Jun;80(3):244-6. | PubMed |

Fethers K, Marks C, Mindel A, Estcourt CS. Sexually transmitted infections and risk behaviours in women who have sex with women. Sex Transm Infect. 2000 Oct;76(5):345-9. | PubMed |

Reisner SL, Mimiaga MJ, Case P, Grasso C, O'Brien CT, Harigopal P, et al. Sexually transmitted disease (STD) diagnoses and mental health disparities among women who have sex with women screened at an urban community health center, Boston, MA, 2007. Sex Transm Dis. 2010 Jan;37(1):5-12. | CrossRef | PubMed |

Muzny CA, Pérez AE, Eaton EF, Agénor M. Psychosocial Stressors and Sexual Health Among Southern African American Women Who Have Sex with Women. LGBT Health. 2018 May/Jun;5(4):234-241. | CrossRef | PubMed |

Logie CH, Navia D, Rwigema MJ, Tharao W, Este D, Loutfy MR. A group-based HIV and sexually transmitted infections prevention intervention for lesbian, bisexual, queer and other women who have sex with women in Calgary and Toronto, Canada: study protocol for a non-randomised cohort pilot study. BMJ Open. 2014 Apr 23;4(4):e005190. | CrossRef | PubMed |

Wang X, Norris JL, Liu Y, Vermund SH, Qian HZ, Han L, et al. Risk behaviors for reproductive tract infection in women who have sex with women in Beijing, China. PLoS One. 2012;7(7):e40114. | CrossRef | PubMed |

McNair R. Risks and prevention of sexually transmissible infections among women who have sex with women. Sex Health. 2005;2(4):209-17. | PubMed |

Massad LS, Xie X, Minkoff H, Darragh TM, D'Souza G, Sanchez-Keeland L, et al. Abnormal pap tests and human papillomavirus infections among HIV-infected and uninfected women who have sex with women. J Low Genit Tract Dis. 2014 Jan;18(1):50-6. | CrossRef | PubMed |

Kerker BD, Mostashari F, Thorpe L. Health care access and utilization among women who have sex with women: sexual behavior and identity. J Urban Health. 2006 Sep;83(5):970-9. | PubMed |

Marrazzo JM, Koutsky LA, Kiviat NB, Kuypers JM, Stine K. Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women. Am J Public Health. 2001 Jun;91(6):947-52. | PubMed |

Marrazzo JM, Koutsky LA, Stine KL, Kuypers JM, Grubert TA, Galloway DA, Kiviat NB, et al. Genital human papillomavirus infection in women who have sex with women. J Infect Dis. 1998 Dec;178(6):1604-9. | PubMed |

Vodstrcil LA, Walker SM, Hocking JS, Law M, Forcey DS, Fehler G, et al. Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clin Infect Dis. 2015 Apr 1;60(7):1042-53. | CrossRef | PubMed |

Sturm RM, Breyer BN, Li CS, Subak LL, Brown JS, Shindel AW. Prevalence of overactive bladder and stress urinary incontinence in women who have sex with women: an internet-based survey. J Womens Health (Larchmt). 2014 Nov;23(11):935-40. | CrossRef | PubMed |

Marrazzo JM, Thomas KK, Fiedler TL, Ringwood K, Fredricks DN. Relationship of specific vaginal bacteria and bacterial vaginosis treatment failure in women who have sex with women. Ann Intern Med. 2008 Jul 1;149(1):20-8. | PubMed |

Gorgos LM, Marrazzo JM. Sexually transmitted infections among women who have sex with women. Clin Infect Dis. 2011 Dec;53 Suppl 3:S84-91. | CrossRef | PubMed |

Marrazzo JM, Thomas KK, Fiedler TL, Ringwood K, Fredricks DN. Risks for acquisition of bacterial vaginosis among women who report sex with women: a cohort study. PLoS One. 2010 Jun 15;5(6):e11139. | CrossRef | PubMed |

Forcey DS, Walker SM, Vodstrcil LA, Fairley CK, Bilardi JE, Law M, et al. Factors associated with participation and attrition in a longitudinal study of bacterial vaginosis in Australian women who have sex with women. PLoS One. 2014 Nov 20;9(11):e113452. | CrossRef | PubMed |

Barbosa RM, Koyama MA. [Women who have sex with women: estimates for Brazil]. Cad Saude Publica. 2006 Jul;22(7):1511-4. | PubMed |

Bell AV, Ompad D, Sherman SG. Sexual and drug risk behaviors among women who have sex with women. Am J Public Health. 2006 Jun;96(6):1066-72. | PubMed |