Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 37, Number 1, March 2005

IN THIS ISSUE

For years, the sexual and reproductive health needs of women who have sex with women have received inadequate attention from researchers and health care workers. Since the late 1990s, however, evidence that women can acquire sexually transmitted diseases (STDs) from female partners has sparked interest in how to promote—indeed, in what constitutes—safer sex between women. In this issue of Perspectives on Sexual and Reproductive Health (see article), Jeanne M. Marrazzo and colleagues report on what lesbian and bisexual women participating in focus group discussions had to say about their sexual practices, risk perceptions and knowledge of STD risk.

For years, the sexual and reproductive health needs of women who have sex with women have received inadequate attention from researchers and health care workers. Since the late 1990s, however, evidence that women can acquire sexually transmitted diseases (STDs) from female partners has sparked interest in how to promote—indeed, in what constitutes—safer sex between women. In this issue of Perspectives on Sexual and Reproductive Health (see article), Jeanne M. Marrazzo and colleagues report on what lesbian and bisexual women participating in focus group discussions had to say about their sexual practices, risk perceptions and knowledge of STD risk.

The Seattle-area women, some of whom had had bacterial vaginosis or an STD, revealed that sexual practices that could present a means of STD transmission between women are common, but preventive measures—washing hands after penetrative sex or using condoms with sex toys, for instance—are not. Many of the women's comments reflected woeful misinformation about the risk of STDs, particularly the perception that same-sex behavior carries no risk; others brought out the need for services from providers who are knowledgeable about and sensitive to the sexual and reproductive health needs of lesbian and bisexual women. The researchers outline several implications for the design of risk reduction interventions for women who have sex with women. Paramount among these is the need to adequately convey that the risk of STD transmission between women is real.

In a related viewpoint article (see article), Greta R. Bauer and Linda D. Wayne praise the study by Marrazzo and her team as "one of only a handful to collect the cultural information necessary to plan effective sexual health interventions for sexual minority populations." Studies like this one and the interventions they inform are crucial, the authors argue, to overcoming the distrust of health professions that years of oppression has fostered in many gay, lesbian, bisexual and trans\gender communities.

Also in This Issue

• Ask a preadolescent and her parent each to assess the youngster's risk and preventive behaviors; the answers may differ, but both perspectives may afford a window on the youth's risk of initiating sexual intercourse at an early age. Studying a sample of black fourth and fifth graders in the South, Rex Forehand and colleagues found that the behaviors that distinguish youngsters who intend to initiate intercourse soon from those who do not vary in seriousness and in how obvious they are to parents (see article). Therefore, the investigators conclude, it is important for programs aimed at preadolescents to target both "overt and covert" risk behaviors.

• Pharmacists play a critical role in women's access to emergency contraceptive pills, especially in areas with large rural populations—which makes Kristi Van Riper and Wendy L. Hellerstedt's report of South Dakota pharmacists' experiences with the method (see article) disheartening. The researchers found that even in pharmacies that carry the method, a substantial proportion of pharmacists are not comfortable counseling women about it. Moreover, about 20–40% of all pharmacists who participated in a statewide survey gave incorrect answers to basic questions about characteristics of the method. The authors call on formal and continuing education programs for pharmacists to strengthen their curricula pertaining to reproductive medicines and pharmacists' counseling skills.

• Youth living in one-parent households are more likely than their peers living with two parents to engage in risky sexual behaviors; Roy F. Oman and colleagues show (see article) that the disparity may reflect differences in "youth assets"—values and social supports that help young people avoid potentially harmful behaviors. In a sample of inner-city Midwestern adolescents, good health practices, peer role models and high levels of family communication were associated with protective behaviors for adolescents living with one parent; in general, the more assets, the greater the protection. Fewer associations were found for adolescents in two-parent households. If the findings are confirmed in more generalizable samples, they could help youth development programs shape interventions to reduce sexual risk among adolescents living with one parent.

• Incarcerated women who previously engaged in risky sexual behavior may do so again after their release. In analyses of a sample of women incarcerated in Rhode Island in 2002–2003 (see article), Cynthia Rosengard and colleagues find that these women base their decisions regarding protective behavior—specifically, condom use—partly on whether they are having sex with a main or casual partner. They recommend that risk reduction programs for incarcerated women emphasize the importance of using condoms with all partners, regardless of women's own sense of commitment to the relationship or perceptions of their partner's risk status. Such interventions "could greatly benefit the individual woman as well as the community to which she returns."

• In a special report (see article), Risha Foulkes and coauthors describe a meeting convened by The Alan Guttmacher Institute and the Latino Issues Forum in early 2004, at which community leaders and researchers developed an action plan intended to guide efforts to improve sexual and reproductive health care for Latinas. The plan outlines five priorities: improving Latinas' access to information and services, addressing the specific needs of adolescents and young adult women, exploring Latinas' use of abortion, strengthening advocacy and communication efforts, and designing research for identifying gaps in knowledge about Latinas' sexual and reproductive health. The meeting made clear that close collaboration between researchers and advocates is a key element in the development of successful policies and programs to serve the Latina community.

—The Editors