The social and cultural significance of women’s sexual identities should guide health promotion: an analysis of the Sydney Women and Sexual Health (SWASH) survey

25 August 2015

Our analysis aimed to identify the major risk behaviors and health issues for young lesbian, bisexual and queer women, and combine this with lifestyle and community engagement data to guide targeted health promotion for these groups.We conducted statistical analysis of 379 self-complete surveys from women aged 17–30 years attending lesbian, gay, bisexual, trans, and queer (LGBTQ) community events during the Sydney Gay and Lesbian Mardi Gras Festival period in February 2010 and 2012. We found concerning rates of tobacco, alcohol, and illicit drug use across all groups; a mental illness diagnosis and formal psychological support access were common. Queer women had the highest rates of illicit drug use, experiences of sexual coercion, and anti-LGBTQ discrimination. They were also the most proactive with their health. Bisexual women had low STI testing despite having high rates of sexual activity with both men and women. Lesbian women had the poorest uptake of Pap smears and STI testing. Findings demonstrate that meaningful sexual behavior is irrelevant for the majority of health disparities affecting sexual minority women. Meaningful engagement with contemporary sexual identities and their local social and cultural significance is essential for the development of appropriate and effective targeted public health interventions.