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February 5, 2026The Journal of Sexual Medicine0 citations

(O-41) Sexual behavior peculiarities in women who have sex with women: a comparative cross-sectional study between lesbian and bisexual women

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DCD A L CantelliSOS H P OkanoSFS A Franceschini

Key Points

  • This study aims to compare the sexual practices and STI prevention knowledge among lesbian and bisexual women who have sex with women.
  • Conducted an online survey using Respondent-Driven Sampling (RDS) nationwide.
  • Included homosexual and bisexual women aged 18 years or older.
  • Excluded pregnant postpartum women and trans women without genital gender-affirming surgery.
  • Analyzed questionnaire responses from eligible participants.
  • Bisexual women reported more sexual relationships with men (95.0% vs 63.7%).
  • Greater use of barrier methods for anal sex was reported by bisexual women (21.6% vs 9.6%).
  • Lesbians engaged in more insertive vaginal sex (94.3% vs 83.9%) and anal sex (30.6% vs 21.1%).
  • Higher HPV vaccination rates were found among bisexual women (58.8% vs 47.1%).
  • No differences in self-reported STI infections or use of condoms, PrEP, dental dams, and gloves.

Abstract

Abstract Introduction Despite women who have sex with women (WSW) being exposed to sexually transmitted infections (STIs), they receive little guidance on prevention. In parallel, a lack of knowledge regarding the sexual practices of these groups also hinders the provision of guidance for effective prevention. Objectives To compare the sexual practices of WSW, as well as the knowledge and use of STI prevention methods among lesbian and bisexual women. Method This study is an online survey, with recruitment through the Respondent-Driven Sampling (RDS) method launched nationwide. Homosexual and bisexual women aged 18 years or older were included; pregnant women, postpartum women, and trans women without genital gender affirming surgery were excluded. Results Of the 390 participants who completed the questionnaire, 356 forms were considered eligible for this analysis. Regarding sexual practices, bisexual women reported more relationships with men (95.0% vs 63.7%, p 0.001) and greater use of barrier methods for anal sex (21.6% vs 9.6%, p = 0.002). Lesbians, otherwise, reported more insertive vaginal sex (94.3% vs 83.9%, p = 0.002) and anal sex (30.6% vs 21.1%, p = 0.041). There was no difference in other evaluated sexual practices (oral sex, receptive vaginal, and receptive anal sex). Regarding STI prevention, HPV vaccination was higher among bisexual women (58.8% vs 47.1%, p = 0.028). No differences were observed concerning self-reported previous STI infection (HPV, syphilis, trichomonas, chlamydia, and herpes), nor regarding the use of condoms, PrEP, dental dams, and gloves. Conclusion The higher rate of sexual relationships with men among bisexual women and the sexual practices reported by WSW underscore the need for specific sexual health approaches for each group, suggesting, furthermore, the active addressing of these issues in medical consultations. Financing No conflict.

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Cite This Study

Cantelli et al. (2026) studied this question.

synapsesocial.com/papers/6984358ff1d9ada3c1fb4772https://doi.org/10.1093/jsxmed/qdag002.040
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