Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 2001 Jun;91(6):947–952. doi: 10.2105/ajph.91.6.947

Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women.

J M Marrazzo 1, L A Koutsky 1, N B Kiviat 1, J M Kuypers 1, K Stine 1
PMCID: PMC1446473  PMID: 11392939

Abstract

OBJECTIVES: The purpose of this study was to examine frequency of and attitudes toward Papanicolaou (Pap) test screening in women who have sex with women (WSW) and to determine prevalence of genital human papillomavirus (HPV). METHODS: Women were eligible if they reported having engaged in sex with another woman in the preceding year Medical and sexual histories were obtained. Cervical specimens for Pap tests and cervical and vaginal specimens for HPV DNA testing were collected. RESULTS: HPV DNA was detected in 31 of 248 WSW (13%). Women who had never had sex with men were less likely to have undergone pelvic examinations and had fewer recent Pap tests. Reasons for not undergoing Pap tests included lack of insurance, previous adverse experiences, and belief that Pap tests were unnecessary. CONCLUSIONS: Despite the occurrence of genital HPV, WSW do not receive adequate Pap test screening. Pap test screening recommendations should not differ for WSW, regardless of sexual history with men.

Full Text

The Full Text of this article is available as a PDF (87.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bailey J. V., Kavanagh J., Owen C., McLean K. A., Skinner C. J. Lesbians and cervical screening. Br J Gen Pract. 2000 Jun;50(455):481–482. [PMC free article] [PubMed] [Google Scholar]
  2. Calle E. E., Flanders W. D., Thun M. J., Martin L. M. Demographic predictors of mammography and Pap smear screening in US women. Am J Public Health. 1993 Jan;83(1):53–60. doi: 10.2105/ajph.83.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Carroll N. M. Optimal gynecologic and obstetric care for lesbians. Obstet Gynecol. 1999 Apr;93(4):611–613. [PubMed] [Google Scholar]
  4. Champion V. L., Scott C. R. Reliability and validity of breast cancer screening belief scales in African American women. Nurs Res. 1997 Nov-Dec;46(6):331–337. doi: 10.1097/00006199-199711000-00006. [DOI] [PubMed] [Google Scholar]
  5. Diamant A. L., Schuster M. A., Lever J. Receipt of preventive health care services by lesbians. Am J Prev Med. 2000 Oct;19(3):141–148. doi: 10.1016/s0749-3797(00)00192-6. [DOI] [PubMed] [Google Scholar]
  6. Diamant A. L., Schuster M. A., McGuigan K., Lever J. Lesbians' sexual history with men: implications for taking a sexual history. Arch Intern Med. 1999 Dec 13;159(22):2730–2736. doi: 10.1001/archinte.159.22.2730. [DOI] [PubMed] [Google Scholar]
  7. Edwards A., Thin R. N. Sexually transmitted diseases in lesbians. Int J STD AIDS. 1990 May;1(3):178–181. doi: 10.1177/095646249000100304. [DOI] [PubMed] [Google Scholar]
  8. Einhorn L., Polgar M. HIV-risk behavior among lesbians and bisexual women. AIDS Educ Prev. 1994 Dec;6(6):514–523. [PubMed] [Google Scholar]
  9. Ferenczy A., Bergeron C., Richart R. M. Human papillomavirus DNA in fomites on objects used for the management of patients with genital human papillomavirus infections. Obstet Gynecol. 1989 Dec;74(6):950–954. [PubMed] [Google Scholar]
  10. Ferris D. G., Batish S., Wright T. C., Cushing C., Scott E. H. A neglected lesbian health concern: cervical neoplasia. J Fam Pract. 1996 Dec;43(6):581–584. [PubMed] [Google Scholar]
  11. Hildesheim A., Schiffman M. H., Gravitt P. E., Glass A. G., Greer C. E., Zhang T., Scott D. R., Rush B. B., Lawler P., Sherman M. E. Persistence of type-specific human papillomavirus infection among cytologically normal women. J Infect Dis. 1994 Feb;169(2):235–240. doi: 10.1093/infdis/169.2.235. [DOI] [PubMed] [Google Scholar]
  12. Kennedy M. B., Scarlett M. I., Duerr A. C., Chu S. Y. Assessing HIV risk among women who have sex with women: scientific and communication issues. J Am Med Womens Assoc. 1995 May-Aug;50(3-4):103–107. [PubMed] [Google Scholar]
  13. Koh A. S. Use of preventive health behaviors by lesbian, bisexual, and heterosexual women: questionnaire survey. West J Med. 2000 Jun;172(6):379–384. doi: 10.1136/ewjm.172.6.379. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Kurman R. J., Henson D. E., Herbst A. L., Noller K. L., Schiffman M. H. Interim guidelines for management of abnormal cervical cytology. The 1992 National Cancer Institute Workshop. JAMA. 1994 Jun 15;271(23):1866–1869. [PubMed] [Google Scholar]
  15. Marrazzo J. M., Koutsky L. A., Stine K. L., Kuypers J. M., Grubert T. A., Galloway D. A., Kiviat N. B., Handsfield H. H. Genital human papillomavirus infection in women who have sex with women. J Infect Dis. 1998 Dec;178(6):1604–1609. doi: 10.1086/314494. [DOI] [PubMed] [Google Scholar]
  16. Mathews W. C., Booth M. W., Turner J. D., Kessler L. Physicians' attitudes toward homosexuality--survey of a California County Medical Society. West J Med. 1986 Jan;144(1):106–110. [PMC free article] [PubMed] [Google Scholar]
  17. McCaffrey M., Varney P., Evans B., Taylor-Robinson D. Bacterial vaginosis in lesbians: evidence for lack of sexual transmission. Int J STD AIDS. 1999 May;10(5):305–308. doi: 10.1258/0956462991914168. [DOI] [PubMed] [Google Scholar]
  18. O'Hanlan K. A., Crum C. P. Human papillomavirus-associated cervical intraepithelial neoplasia following lesbian sex. Obstet Gynecol. 1996 Oct;88(4 Pt 2):702–703. doi: 10.1016/0029-7844(96)00206-2. [DOI] [PubMed] [Google Scholar]
  19. Price J. H., Easton A. N., Telljohann S. K., Wallace P. B. Perceptions of cervical cancer and Pap smear screening behavior by women's sexual orientation. J Community Health. 1996 Apr;21(2):89–105. doi: 10.1007/BF01682301. [DOI] [PubMed] [Google Scholar]
  20. Rankow E. J., Tessaro I. Cervical cancer risk and Papanicolaou screening in a sample of lesbian and bisexual women. J Fam Pract. 1998 Aug;47(2):139–143. [PubMed] [Google Scholar]
  21. Roberts S. J., Sorensen L. Health related behaviors and cancer screening of lesbians: results from the Boston Lesbian Health Project. Women Health. 1999;28(4):1–12. doi: 10.1300/J013v28n04_01. [DOI] [PubMed] [Google Scholar]
  22. Robertson P., Schachter J. Failure to identify venereal disease in a lesbian population. Sex Transm Dis. 1981 Apr-Jun;8(2):75–76. doi: 10.1097/00007435-198104000-00008. [DOI] [PubMed] [Google Scholar]
  23. Sawaya G. F., Kerlikowske K., Lee N. C., Gildengorin G., Washington A. E. Frequency of cervical smear abnormalities within 3 years of normal cytology. Obstet Gynecol. 2000 Aug;96(2):219–223. doi: 10.1016/s0029-7844(00)00882-6. [DOI] [PubMed] [Google Scholar]
  24. Sell R. L., Wells J. A., Wypij D. The prevalence of homosexual behavior and attraction in the United States, the United Kingdom and France: results of national population-based samples. Arch Sex Behav. 1995 Jun;24(3):235–248. doi: 10.1007/BF01541598. [DOI] [PubMed] [Google Scholar]
  25. Skinner C. J., Stokes J., Kirlew Y., Kavanagh J., Forster G. E. A case-controlled study of the sexual health needs of lesbians. Genitourin Med. 1996 Aug;72(4):277–280. doi: 10.1136/sti.72.4.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Sonnex C., Strauss S., Gray J. J. Detection of human papillomavirus DNA on the fingers of patients with genital warts. Sex Transm Infect. 1999 Oct;75(5):317–319. doi: 10.1136/sti.75.5.317. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Stevens P. E., Hall J. M. Stigma, health beliefs and experiences with health care in lesbian women. Image J Nurs Sch. 1988 Summer;20(2):69–73. doi: 10.1111/j.1547-5069.1988.tb00033.x. [DOI] [PubMed] [Google Scholar]
  28. White J. C., Dull V. T. Health risk factors and health-seeking behavior in lesbians. J Womens Health. 1997 Feb;6(1):103–112. doi: 10.1089/jwh.1997.6.103. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES