LESBIAN AND BISEXUAL WOMEN IN SMALL CITIES - AT RISK FOR HIV

Objectives. Women who have sex with women are a relatively hidden grou p that has been overlooked in most AIDS research and prevention effort s, primarily because the efficiency of HIV transmission between female partners is believed to be low. Although data are scant, it is common ly assumed that members of this population are not at high risk for HI V infection. However, a recent study of lesbian and bisexual women liv ing in the San Francisco Bay area reported a relatively high seropreva lence rate and has raised additional questions about this group's HIV risk The present study, the first to focus on lesbian and bisexual wom en living outside major AIDS epicenters, provides additional evidence. It describes risk factors for HIV transmission among lesbian and bise xual women living in small cities in four geographic regions of the Un ited States. Methods. On three consecutive evenings in 1992, members o f the research team distributed anonymous structured written surveys t o women patrons as they entered gay bars in each of 16 small cities. R esults. Almost 17% of bisexual respondents and 0.5% of lesbians report ed having had unprotected vaginal or anal sex with a male during the t wo months prior to the survey. Almost IO percent of bisexual women and 8.8% of lesbians in the sample reported a history of injection drug u se. Among those women surveyed who said they had been tested, 1.4% rep orted they were infected with HIV. Conclusions. Self-identified sexual orientation was highly consistent with recent sexual behavior. HIV ri sk related to sexual behavior was concentrated among self-identified b isexual women. The prevalence of injection drug use was substantial am ong both bisexual and lesbians. Developers of HIV risk behavior progra ms should take the prevalence of these risk behaviors into considerati on in the design of effective HIV prevention interventions tailored to the needs of this hidden population.