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Perception of HIV and Safer Sexual Behaviors among Lesbians

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There is little data on female-to-female transmission of HIV. Some women who have sex with women (WSW) have other high-risk behaviors that could lead to HIV infection. The belief that WSW are at no risk maylead to unsafe sexual practices. In this study, a convenience sample of 78 women was surveyed in order to explore the perception of HIV risk among lesbians, their sexual behaviors, and their sources of information about safer sex. Fifty-three percent reported theywer e at low risk for contracting HIV. Women reported knowledge of barrier methods (89% to 99%) and no sex during menstruation (92%). However, 35% to 40% reported no knowledge of less common safer sex practices. Women reported their source of knowledge as media (36%), workshops (22%), and friends (12%). Eighty-five percent stated that their health care provider knew theywer e lesbian, but only 15% reported receiving safer sex education. Nurses and nurse practitioners are aptlypoised to provide critical HIV education and health care for this population.

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Review of Literature

In a study of 4,501 U.S. female physicians, Brogan, Frank, Elon, and O'Hanlan (2001), used three concepts to measure sexual orientation: (a) sexual identity only, (b) sexual behavior only, and (c) identity and behavior combined. In contrast to other researchers, they described almost 100% consistency between sexual identity and behavior. The high level of education and medical knowledge of their study population may have skewed study results. For this study, both individual behavior and sexual

Method

Approval was obtained from the Hartford Hospital's Human Subjects Committee and the Board of Directors of the North East Women's Musical Retreat. A yearly occurrence since 1981, the event is attended by women diverse in age, race and ethnicity, education, occupation, and sexual orientation. Their common bond is a belief in “women's culture” and enjoyment of “women's music.”

Procedure

The lesbian community has several subcultures with particular norms and values. In some communities, certain behaviors such as intravenous drug use and having sex with men are not acceptable. However, women may not admit to such practices in order to maintain acceptance or status in their community. Consequently, an anonymous survey was essential and distributed in the registration packet of the women's music festival.

A sealed box in a separate but public area at the music festival and a

Results

A convenience sample of 78 women predominately White (86%) with a master's degree education or beyond (49%) and income above $35,000 (45%) participated in the study. Mean age was 46 years (SD = 8.6). Women reported not having a partner (29%), living separately from a partner (27%), living with a partner (27%), and in a same-gender committed relationship (17%).

Discussion

Lesbian women's belief that they are not at risk for contracting HIV is a repeated finding and has been termed lesbian immunity. This belief may expose WSW to a much higher risk for contracting HIV than is generally perceived. In this survey, only 30% of women worried about contracting HIV and 53% believed they were at low risk. This result is similar to the findings of Montcalm and Myer (2001) in which 39% of lesbians surveyed did not perceive that they had any risk for contracting HIV.

Implications for Nursing

Nurses and nurse practitioners take sexual orientation and risk behavior histories as well as provide education on safer sex. Many health care providers feel awkward in this process with any patient and even more so with someone whose lifestyle is unfamiliar. Additionally, WSW are often reluctant to disclose their sexual orientation or their sexual behaviors due to fear of rejection, misunderstanding, discrimination, or negative consequences, or perhaps due to not perceiving the need for health

Acknowledgments

The authors wish to thank Rose Maljanian, MS, for research assistance; Sheryl Horowitz, PhD, for statistical analyses; and Valerie Banfi for library assistance. We also express appreciation to the women of the North East Women's Musical Retreat for their participation.

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