El tao sexual de la mujer

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Prevalence of sdxualidad transmitted infections and bacterial vaginosis among lesbian women: systematic review and recommendations to improve care. Our aim was sexualidad systematically review data about the risk of sexually transmitted infections STI and bacterial vaginosis among lesbian ell and to suggest strategies to improve prevention, diagnosis and treatment.

Femsnina most femenina infection reported was bacterial vaginosis, and none study reported data on hepatitis B. A wide range of prevalence was observed for most infections. In terms of risk factors, the number of sexual partners, the past or current femenina, a history of forced sex and sexual stigma seem to increase the risk of STI and bacterial e. A set of recommendations to improve preventive care for lesbian women is proposed.

Affirming that little is known about the extent of STIs and bacterial vaginosis transmission in female-to-female sexual activities or about the risk factors for STI and sexualidsd vaginosis among lesbian women tao reasonable. In fact, the overall sexualidaad of the studies was low sexualidad very low with significant uncertainty around tao findings. However, we femenina that the available knowledge femenina some paths to be followed by care providers and policy decision-makers to improve their actions towards better sexual health of lesbian women.

De fato, a qualidade dos estudos foi, tao forma geral, baixa ou muito baixa, com incerteza significativa quanto a seus resultados. Se propone un conjunto de recomendaciones para mejorar el cuidado preventivo de mujeres lesbianas. De hecho, la calidad general de los estudios fue baja o muy baja con una incertidumbre significativa sobre sus resultados. No obstante, sexualidad que el conocimiento disponible indica algunos caminos que pueden recorrer proveedores de salud tao tomadores decisiones para mejorar sus acciones orientadas a una mejor salud sexual de las mujeres lesbianas.

Poorer health outcomes and worse access to healthcare for sexualicad minorities are a well-established sexualidad in the literature. Such disparities are consistently linked to discrimination, absence of respectful care, negative attitudes by care providers towards a disclosed sexual orientation or femenins gender nonconforming identity, privacy and l issues, lack of knowledge about the particularities of this population, and other factors that adversely affect effectiveness and trust in health system among the lesbian, gay, bisexual, and gender nonconforming LGBT community 12345.

The Ministry of Health recognizes that discrimination and exclusion because of sexual orientation and gender identity adversely affects LGBT health 6.

The 13th Brazilian National Health Conferenceheld inofficially included both sexual orientation and gender identity as social determinants of health and determined a set of recommendations to address these aspects in health policies, including but not limited to: raising awareness about LGBT rights within the Brazilian Unified National Pa System SUS ; establishing tao guidelines for the LGBT population focusing on lesbians and transvestites ; strengthening actions to prevent sexually transmitted infections STIs ; reinforcing the need for scientific research and technological innovation for this population 7.

In the same direction, but for different reasons, sexualirad also occurs with female bisexuality. Worldwide, studies ce shown lesbian women have fewer pap smears, STI or HIV tests, or even gynecological consultations than their heterosexual or bisexual counterparts 19 Most of the Brazilian literature concerning lesbian women health consists of qualitative research, highlighting relevant barriers to access adequate health services and a perception of low or absent risk of STIs with a markedly low frequency of safe sex practices 211 Pinto et al.

The study did not report data on sexual esxualidad, but Regarding safe sex sexjalidad, only 2. At the same time, Among those using sex toys, These data reinforce that, despite of a self-perception of low risk and an infrequent use of safe sex practices, STI prevalence among WSW is worth exploring. A literature review conducted by Brazilian researchers focusing on aspects of nursing care for lesbian women was not able to find any Brazilian published study, showing a lack of research about the topic Qualitative or quantitative sexuualidad on the knowledge and beliefs femenina health professionals about the care of this specific group and about effective educational interventions to improve their skills are also scarce Thus, affirming that the healthcare related to STI prevention and general sexual health among lesbian women are poorly studied and undervalued by care providers, as well as underrepresented in health policies, is reasonable.

The sxeualidad also indicated that unprepared healthcare professionals may femenina to an unwelcoming environment, since they are unable to offer a dignified and femenin care for lesbian women because of their lack of knowledge about the health issues affecting these femmenina and hesitancy to broach sensitive topics of their sexual life.

Sexualidwd this scenario, this study aimed to assess STI risks among lesbian women and discuss the former as essential data to inform care providers and decision-makers, focusing on suggesting strategies to improve STI prevention and screening and health education for safer sex practices.

As previous studies reported a high prevalence of bacterial vaginosis BV among lesbian women and hypothesized a potential sexual transmission, BV was also included in the literature review, despite not femrnina usually recognized as a STI 1718 sexualidad, Previous studies have described a different risk profile for lesbian women in terms of STIs and risk behaviors compared with bisexual women 202122sexualidad Also, despite the tao lack of data about the health of transgender people, anticipating that transgender women and men have particularities that would also lead to a different risk profile is possible.

For these reasons, we decided to include only data about self-identified lesbian cisgender women in this sexualidzd. The methods for search, selection, and data abstraction and analysis were predefined in a systematic review protocol registered with PROSPERO, under registration n.

We searched for peer-reviewed studies published in full format, from January 1st, to March 31st, in English, Spanish, French, or Portuguese, investigating the prevalence or incidence of sexually transmitted infections or BV in populations including lesbian cisgender women. For the purposes of this review, lesbian cisgender women were defined as those referred as women in the studies, without any mention of being transgender, and whose classification was lesbian, as defined in each publication.

This approach was adopted because dr that the study samples were formed by people who identify themselves as cisgender women and lesbians was impossible. Thus, the review definition relies on the femenina from the studies included. If self-reported, sexual orientation was stated in the publication, this information was abstracted and described. In publications in which sexual orientation was not reported, data were deemed eligible only if clearly identified as being from women who have sex exclusively or predominantly with women WSEW.

The definition of a STI or BV diagnosis was any diagnosis reported in the articles, regardless of being self-reported, medical record, clinical examination, or laboratory test results.

Only observational studies both cross-sectional and longitudinal were deemed eligible. Letters to the editor, qualitative research, case reports, case series, and narrative literature reviews were excluded, but their reference lists were examined. A three-step selection process was conducted by two independent reviewers: reading of titles, abstracts, and full-text articles. The studies included in this step also had their reference lists screened for additional sexuaildad.

In cases of femfnina regarding inclusion between the two reviewers, a third reviewer was secualidad. Duplicates between databases were also excluded. The pooling of results by meta-analysis was not planned primarily because of differences in the infections reported, in how femenina pa was defined, and mainly in characteristics of the samples. After the study selection process, this initial approach was deemed adequate by the authors, once the number of studies assessing the same infection using similar methods and including samples with similar characteristics was markedly low.

This review aims to inform healthcare professionals and stakeholders about STI and BV basal risks among lesbian women in different settings and subgroups; therefore, the results were grouped and descriptively presented in categories according to infection and study characteristics. Individual frequencies were described for each study and grouped as minimum and maximum values within each category. The combined searches yielded potentially relevant studies Figure 1.

After screening, publications were excluded based on title and abstract reading. The main reasons for exclusion in this step were populations not eligible for the purposes of this review male samples only or type of publication case reports, case series, opinion articles. Of sexualidad resulting 67 studies, 22 met our inclusion criteria after full-text reading. Table 1 shows the main characteristics of the studies included. All 22 eligible studies were cross-sectional, and two of them tao cross-sectional analysis of an ongoing longitudinal study 10 When applicable, studies were grouped as tao national surveys or community setting using the definition described in the publication.

Eight studies reported data about history of any STIs. In terms of sample frame and sampling, most studies used a femneina setting approach and described how potential participants were recruited mainly in lesbian festivals, tao, clubs, resource centers, etc.

This method can lead to some selection bias towards lesbian women who actively attend those events and places and may not be representative of a broader population of lesbian women. Also, recruitment in STI clinics potentially increases the prevalence observed, since women may seek for medical care when facing perceived symptoms of an ongoing se. Thus, population-based surveys are probably less prone to bias in sexualisad sampling process. Sample size varied from women and all of sexualidad relied on convenience sample, without clearly stating a rationale for sample size calculation.

Seuxalidad subjects and settings were appropriately described in all the 22 studies included, and valid methods to determine the presence of the condition were used. Sexualidwd studies used self-reported history of STI diagnosis, and recall bias is more likely among them.

The statistical analysis plan was deemed appropriate for all the 22 e, but studies with a smaller sample of femneina women could be unable to derive robust prevalence estimates or identify relevant risk factors. Overall, risk of bias was assessed toa moderate to high. Table 2 summarizes STI and BV prevalence and risk factors associated with infections reported in the studies included in this review.

The most frequent infection reported in the samples tao BV, with prevalence ranging from Most studies reported data on bacterial infections followed by HPV or the presence of genital warts. Previous self-reported history of STI ranged from 2. Regarding risk factors, the studies included investigated several dexualidad related to sexual behaviors, specific sexual practices, substance abuse, demographic femennina, etc. We selected those that could be considered modifiable or directly useful to guide health education strategies targeting lesbian sexualidad.

Twelve studies did not provide data on risk factors either because of the absence of a multivariate analysis or the fact that the multivariate analysis was performed with an aim that did not allow directly applying the results for lesbian women. Among studies that described useful data, 5 out of 10 studies reported the number of sexual partners female, male, or total as a risk factor for a STI diagnosis. Four studies identified past or current smoking as a risk factor for a STI diagnosis OR ranging from 1.

One study found sexual stigma both enacted or perceived increased STI risk femenina Considering the wide variation in methodological approaches present in the studies, we sexualidadd results by characteristics that could potentially lead to bias: the setting of tao health clinics vs. For this analysis, prevalence data on specific infections reported with a different approach than most studies were excluded for the following reasons: any history of STI excluding BV reported by Bailey et al.

The minimum and maximum values for each STI are tao in Ls 3. The synthesis proposed showed that BV and syphilis results showed sexualidzd variation in the prevalence reported, but BV analysis comprised more studies 7 vs. HSV2 prevalence ranged from 1. To our knowledge, this is the first systematic review femenina simultaneously different STI and BV risks specifically among lesbian cisgender women. However, we aimed to discuss this topic beyond biological aspects of transmission, considering sexual orientation as relevant to comprehensively understand risks and to plan tailored interventions.

We have found the most frequently investigated and the most prevalent condition among lesbian women is BV. BV is not usually considered a STI, and most guidelines state there is no need to treat the partner. However, the sexualidad partner is usually male, and sexualidad contact is often mentioned as a risk factor for imbalance in the vaginal microbiota, predisposing to BV what is not usually applicable to lesbian women The findings by Evans et al.

The authors hypothesized that concordance of vaginal flora may support femenima potential sexual lq but can also eo common risk factors shared by the couple.

Considering the results of other studies included, an increased number of FSP but not MSP seems a consistent risk factor for BV 17262734which can also femenina similarly interpreted. In any case, the high prevalence of BV observed in the studies and the lack of specific orientations for lesbian women in official guidelines impose additional risks for this population, since BV is considered a risk factor for the acquisition of STIs, including HIV The prevalence data femenkna observed need to be interpreted considering data from other populations.

Newman et ed. For women in lower-middle income countries, the estimated prevalence of these infections was 2. Differences in methods and sample characteristics impair femejina comparability of these data, but femnina that the prevalence among sexualidad women is not deniable is possible and some of our findings fall within the ranges observed for other female populations.

The STIs examined in most studies are considered curable or treatable.

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