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Catherine H. Mercer, PhD, Julia V. Bailey, MD, Anne M. Johnson, MD, Bob Erens, MA, Kaye Wellings, MSc, Kevin A. Fenton, PhD and Andrew J. Copas, PhD

Catherine H. Mercer and Andrew J. Copas are with the Centre for Sexual Health and HIV Research at University College London, London, England. At the time of the study, Julia V. Bailey was with Kings College London, London. Anne M. Johnson is with the Department of Primary Care and Population Sciences at University College London, London. Bob Erens is with the National Centre for Social Research, London. Kaye Wellings is with the London School of Hygiene and Tropical Medicine, London. Kevin A. Fenton is with the Division of STD Prevention, National Centers for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga.

Correspondence: Requests for reprints should be sent to Catherine Mercer, Centre for Sexual Health and HIV Research, University College London, Mortimer Market Centre, off Capper Street, London, WC1E 6JB, England (e-mail: cmercer{at}gum.ucl.ac.uk).

Objectives. We estimated the prevalence of same-sex experience among women and compared women reporting sex with women and men and women reporting sex exclusively with women with women reporting sex exclusively with men, in terms of sociodemographics and sexual, reproductive, and general health risk behaviors and outcomes.

Methods. We used a British probability survey (n=6399 women, aged 16 to 44 years) conducted from 1999 to 2001 with face-to-face interviewing and computer-assisted self-interviewing.

Results. We found that 4.9% of the women reported same-sex partner(s) ever; 2.8% reported sex with women in the past 5 years (n=178); 85.0% of these women also reported male partner(s) in this time. Compared with women who reported sex exclusively with men, women who reported sex with women and men reported significantly greater male partner numbers, unsafe sex, smoking, alcohol consumption, and intravenous drug use and had an increased likelihood of induced abortion and sexually transmitted infection diagnoses (age-adjusted odds ratios=3.07 and 4.41, respectively).

Conclusions. For women, a history of sex with women may be a marker for increased risk of adverse sexual, reproductive, and general health outcomes compared with women who reported sex exclusively with men. A nonjudgmental review of female patients’ sexual history should help practitioners discuss risks that women may face.