HIV seroprevalence and risk behaviors among lesbians and bisexual women in San Francisco and Berkeley, California

Developmental and adjustment issues of gay, lesbian, and bisexual adolescents: a review of the empirical literature

Various studies have reported adjustment problems experienced by gay, lesbian, and bisexual (GLB) adolescents. A primary purpose of this paper is to critically review this literature. Difficulties that have been studied include past suicide attempts, substance use and abuse, conduct problems, and academic concerns. For example, a considerable number of GLB youth report a history of suicide attempts, with prevalence rates ranging from 11 to 42%. However, among other methodological concerns, studies in this area have not used a comparison sample of heterosexual youths. Characteristics of development particular to GLB adolescents are described, the empirical research on adjustment issues is reviewed, and potential risk and protective factors for GLB youths are discussed.

HIV risk profile of drug-using women who have sex with women in 19 United States cities

The objective of this study was to analyze HIV-related risks of women injection drug users (IDU) and crack cocaine users (CCU) who have sex with women (WSW). IDU and CCU women (N = 3856) were recruited from street settings in 19 U.S. cities between 1992 and 1994. For this study, we analyze data on 231 women who reported female sex partners in the 30 days before interview. In the 30 days before interview, 53% of IDUs had shared syringes, and 66% had shared injection supplies. Only 11 women (6%) always used barrier protection while giving oral sex to women and 5 (3%) while receiving oral sex from women in the 30 days before interview. Fifty percent had sex with men as well as women in the previous 30 days. Thirty percent of women who reported sex with men had used condoms for penile-vaginal sex, and 26% for penile-anal sex. In logistic regression analysis modeling sex with men in the previous 30 days, sex work was predictive, "lesbian" self-identification was protective, and the interaction between these two terms was predictive, while controlling for race and age. Differences in risk perception were significant between women who reported varying sexual risks, but not significant between women who reported varying injection-related risks. There is a high prevalence of risky sex and drug behaviors among drug-using WSWs. There is a need for epidemiological studies specifically geared toward studying risk behaviors among WSWs. Risk reduction activities need to focus on injection-related risks, as well as sex-related risks, among WSWs.

Women and the heterosexual transmission of HIV: risks and prevention strategies

Heterosexual intercourse has become a significant means of HIV transmission, even in countries where this was previously not the case. Consequently the promotion of safer sexual practices for heterosexual women and men is of major public health importance. We examine the risks to women of contracting HIV through heterosexual sex, and critically discuss the most commonly recommended strategies for safer sex for heterosexuals. We conclude that all safer sex strategies have limitations, and therefore a wide range of options should be promoted.

Reframing women's risk: social inequalities and HIV infection

Social inequalities lie at the heart of risk of HIV infection among women in the United States. As of December, 1995, 71,818 US women had developed AIDS-defining diagnoses. These women have been disproportionately poor, African-American, and Latina. Their neighborhoods have been burdened by poverty, racism, crack cocaine, heroin, and violence. To explain which women are at risk and why, this article reviews the epidemiology of HIV and AIDS among women in light of four conceptual frameworks linking health and social justice: feminism, social production of disease/political economy of health, ecosocial, and human rights. The article applies these alternative theories to describe sociopolitical contexts for AIDS' emergence and spread in the United States, and reviews evidence linking inequalities of class, race/ethnicity, gender, and sexuality, as well as strategies of resistance to these inequalities, to the distribution of HIV among women.

Lesbian and bisexual women in small cities--at risk for HIV? HIV Prevention Community Collaborative

Objectives.Women who have sex with women are a relatively hidden group that has been overlooked in most AIDS research and prevention efforts, primarily because the efficiency of HIV transmission between female partners is believed to be low. Although data are scant, it is commonly assumed that members of this population are not at high risk for HIV infection. However, a recent study of lesbian and bisexual women living in the San Francisco Bay area reported a relatively high seroprevalence rate and has raised additional questions about this group's HIV risk. The present study, the first to focus on lesbian and bisexual women living outside major AIDS epicenters, provides additional evidence. It describes risk factors for HIV transmission among lesbian and bisexual women living in small cities in four geographic regions of the United States.Methods.On three consecutive evenings in 1992, members of the research team distributed anonymous structured written surveys to women patrons as they entered gay bars in each of 16 small cities.Results.Almost 17% of bisexual respondents and 0.5% of lesbians reported having had unprotected vaginal or anal sex with a male during the two months prior to the survey. Almost 10 percent of bisexual women and 8.8% of lesbians in the sample reported a history of injection drug use. Among those women surveyed who said they had been tested, 1.4% reported they were infected with HIV.Conclusions.Self-identified sexual orientation was highly consistent with recent sexual behavior. HIV risk related to sexual behavior was concentrated among self-identified bisexual women. The prevalence of injection drug use was substantial among both bisexual and lesbians. Developers of HIV risk behavior programs should take the prevalence of these risk behaviors into consideration in the design of effective HIV prevention interventions tailored to the needs of this hidden population.