Purpose The knowledge base of family physicians regarding transmission of sexually transmitted infections (STIs) among lesbians is unclear. There are few publications of studies done on this topic and none in the United States. The objective of this study was to investigate the knowledge base of family physicians regarding STIs among lesbians and to discuss implications for lesbian health care and the population at large if a deficit exists.
Methods A voluntary questionnaire was sent to a random sample of 170 family physicians across Washington State. Questions encompassing the epidemiology of disease, modes of STI transmission, as well as an understanding of lesbian behavior statistically according to current research were included and results were analyzed. The knowledge of physicians was quantified by a score based on percent of correct answers and linked to demographic characteristics of participants.
Results Of 70 respondents, the average percent of correct answers on the knowledge-based portion of the questionnaire was 48%. The transmission routes of both chlamydia and gonorrhea were identified by less than 10% of the respondents. Only 9.5% correctly identified the higher risk of acquiring bacterial vaginosis among women who have sex with women. Seventy-five percent correctly recommended the standard frequency of Pap smear screening for lesbians. Sixty-four percent were unaware of higher HIV-related risk behaviors among women who have sex with both men and women. No significant difference in the knowledge base between genders of physicians was found; however, the difference in knowledge among physicians with varying numbers of years in practice was approaching significance according to t-tests performed, and this was correlated to whether or not physicians received health care education specific to lesbians. Only 48% of physicians reported confidence in counseling lesbians regarding STIs, yet 74% had an interest in learning more.
Conclusion The results of the survey indicate that not all family physicians fully understand the special health concerns of lesbians, especially regarding their risks of acquiring and transmitting STIs. This can profoundly affect the quality of care for lesbians. Health care education specific to lesbians may lead to a stronger knowledge base among physicians; however, further studies are recommended to understand more fully how help family practice physicians counsel this population more adequately.
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