Levatrice Cursos, Rio de Janeiro, Brasil.
Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, Brasil.
Cad Saude Publica. 2019 Mar 25;35(3):e00118118. doi: 10.1590/0102-311X00118118.
Our aim was to systematically review data about the risk of sexually transmitted infections (STI) and bacterial vaginosis among lesbian women and to suggest strategies to improve prevention, diagnosis and treatment. A search strategy for lesbian, STI and bacterial vaginosis was applied to PubMed, LILACS and BDENF databases. Of 387 unique references retrieved, 22 fulfilled the inclusion criteria (cross-sectional studies reporting prevalence for 8 STIs/bacterial vaginosis and history of a STI). The most frequent 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 smoking, a history of forced sex and sexual stigma seem to increase the risk of STI and bacterial vaginosis. The findings of this review are discussed considering guidelines directly addressing the LGBT community's health and relevant studies investigating both safe sexual practices and the intricate relationship between LGBT people and their care providers. 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 bacterial vaginosis among lesbian women is reasonable. In fact, the overall quality of the studies was low or very low with significant uncertainty around their findings. However, we consider that the available knowledge indicates some paths to be followed by care providers and policy decision-makers to improve their actions towards better sexual health of lesbian women.
我们的目的是系统地回顾关于女同性恋者中性传播感染（STI）和细菌性阴道病风险的数据，并提出改善预防、诊断和治疗的策略。应用女同性恋、STI 和细菌性阴道病的搜索策略，对 PubMed、LILACS 和 BDENF 数据库进行了检索。在检索到的 387 篇独特参考文献中，有 22 篇符合纳入标准（报告 8 种 STI/细菌性阴道病患病率和 STI 病史的横断面研究）。报告的最常见感染是细菌性阴道病，没有研究报告乙型肝炎的数据。大多数感染的患病率差异很大。就危险因素而言，性伴侣数量、过去或现在吸烟、被迫性行为史和性耻辱感似乎会增加 STI 和细菌性阴道病的风险。在考虑直接针对 LGBT 社区健康的指南和调查 LGBT 人群及其护理提供者之间复杂关系的相关研究的情况下，讨论了本综述的结果。提出了一套改善女同性恋者预防保健的建议。认为对女同性恋性行为中 STI 和细菌性阴道病传播的程度或女同性恋者中 STI 和细菌性阴道病的危险因素知之甚少是合理的。事实上，这些研究的总体质量较低或非常低，其结果存在很大的不确定性。然而，我们认为，现有知识表明，护理提供者和政策决策者可以遵循一些途径，以改善他们的行动，促进女同性恋者的性健康。
