Sexual behavior of women who have sex with women

Objective:  To assess sexual behavior, use of sexually transmitted infection prevention methods and the sexual function, among women who have sex with women.

Methods:  This nationwide cross-sectional study was conducted from February 2023 to April 2024 using the Respondent Driven Sampling method. Women who have sex with women (WSW) with vaginas and neovagina, aged 18–40 years were included. Data on sociodemographic, clinical history, sexual behavior, and STI prevention were collected. Sexual function was assessed using the Female Sexual Function Index (FSFI).

Results:  A total of 371 forms were analyzed (mean age: 28.7 ± 6.9 years). 82.0% participants reported having penile-vaginal intercourse. Nearly all reported both performing (367; 98.0%) and receiving (360; 97.0%) oral sex. 351 participants (94.6%) reported receptive and 324 (87.4%) reported insertive penetration. Insertive anal sex was reported by 94 participants (25.3%), and receptive anal sex by 87 (23.4%). Only 10 participants (2.7%) reported using barrier methods during oral sex. Based on FSFI scores, 115 participants (31.0%) were at risk for sexual dysfunction.

Conclusion:  Most WSW in Brazil engage in oral and vaginal sex, but the report of STI prevention remains mostly limited to the male condom, with little use of barriers in oral or digital practices. HPV and hepatitis vaccination status are high. 115 participants (31.0%) scoring below the cutoff of 26.55. No significant difference in risk of development of sexual dysfunction between age, educational level, sexual orientation and gender identity.

Keywords
Sexual behavior; Women; Sexually transmitted infections; Aged; Sexual practices; Female sexual function index; Surveys and questionnaires