Sexual Preference Should Not Prevent Regular Pap Smears
Women who do
not have heterosexual relationships may be putting themselves at risk
by not having Pap smears as often as other women, a new study has
out of eight homosexual women were actively shedding HPV, the human
papillomavirus, according to the University of Washington study. HPV
can cause genital warts, cervical dysplasia and, rarely, cervical
detected through Pap smears; however, the study found women who have
sexual relationships with other women have Pap smears less regularly
than other women do. In part, that's because healthcare providers told
them that, as lesbians, they were less likely to be susceptible to
sexually transmitted diseases, including HPV, researchers found.
that you really can't classify women as low risk just because they are
not currently having sex with men," said Dr. Jeanne Marrazzo, an
assistant professor of medicine at the UW School of Medicine.
percent of women who have sex with women have been sexually active with
men at some point in their lives," Marrazzo said. "That confers a risk
of their acquiring the 'usual' STDs we associate with heterosexual
activity. There's a faulty assumption out there: that when a woman
reports being currently sexually active with another woman, the risk
for any STD -- even the chronic viral STDs like herpes and HPV -- is
non-existent. That's just wrong."
The study of
nearly 300 women in the Seattle area found that 13 percent tested
positive for HPV and 4 percent had pre-cancerous changes on a Pap test.
Most of these abnormalities appeared in women who reported no prior
sexual activity with men, or last had sex with men more than a year
before the test.
Women who had
never had sex with men were less likely to have ever received a pelvic
examination, received their first Pap smear at a later age, and had
less frequent Pap smears than other women, the study found. Ten percent
of the women who had never had sex with men said they never had a Pap
smear, while 23 percent had not had a Pap smear in three years.
The most commonly cited reasons for not having a Pap smear were:
- Lack of medical insurance;
- Prior adverse experiences at a Pap smear screening; and
- A belief that they did not need a Pap smear because they were not sexually active with men.
nine women said that a healthcare provider -- usually a physician --
had told them they did not need to get a Pap smear because they were
not sexually active with men.
that providers should take a very good sexual history based on behavior
and potential for exposure, as opposed to just labeling a person as a
member of what you think of as a low-risk group. And regardless of that
sexual history, every woman should have routine Pap tests according to
standard guidelines," said Marrazzo.
should begin getting Pap smears when sexual activity starts or at age
18, whichever is earlier, according to the commonly accepted
recommendation. Once three annual Pap smears show normal results, a
physician may direct the woman to get Pap smears every two years. But
many women should still get annual Pap smears, depending on a variety
of factors that should be discussed with a healthcare provider, the
Study results were published in the June 2001 issue of the "American Journal of Public Health."