Background Public health messages urging women to seek health care services such as sexually transmitted diseases (STD) and cervical cancer screening or family planning services fail to address women who have sex with women (WSW). This negligence may have led to a false sense of security amongst WSW concerning sexual risk behaviour. Research has shown that WSW engaged in more high-risk sexual behaviours than heterosexual women. WSW has been identified as an important vector in the spread of STDs in all populations because of bisexuality. To prevent and reduce transmission of STDs amongst WSW, perceptions of risk for STD amongst WSW need to be understood so that effective interventions may be developed.
Aim To describe the relationship between sexual risk and protective behaviour and STD transmission amongst bisexual minority women with a history of STD.
Methods Life history methods were used to interview 23 African-American bisexual women with a history of STD.
Findings Various themes unfolded during analysis of the patient interviews, including bisexual women's perceptions of STD risk, the context of sexual relationships with women and STD prevention, screening, and treatment practices.
Conclusions The contexts of sexual relationships including multiple or concurrent partner relationships with both men and women placed these women at high risk for STD. Regardless of the type of relationship or belief it is possible to get an STD, protection was often not used. These circumstances identify an extremely high-risk population of women with need for more extensive research to identify strategies for health care interventions.