Few data are available on the sexual behaviors of women of diverse sexual orientations in a low-risk population. The researchers undertook the present study to evaluate sexual behaviors of women of all sexual orientations in primary care settings and their risk for HIV and other STDs.

The subjects -- a total of 1,304 women -- were surveyed by anonymous questionnaire at 33 primary health care sites. The women self-identified as follows: 49 percent heterosexual; 11 percent bisexual; and 40 percent lesbian.

Among the women, 600 reported recent sex with men. Of these, 51 percent reported ever using condoms. Heterosexual women were at highest risk for HIV infection as a result of lack of condom use (P<0.001), especially in high-risk situations. Bisexual women reported a higher rate of substance use with sex than did either lesbians or heterosexual women (P<0.001). Compared with heterosexual or bisexual women, lesbians had higher rates of sex with bisexual men (P<0.001) and injection drug users (P<0.02) and of condom use (P<0.001).

"Women of all sexual orientations, and particularly heterosexual women, engaged in behaviors that put them at risk for HIV and STD," the authors concluded.

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