The cultural significance of women’s sexual identities should guide health promotion

Abstract

The Sydney Women and Sexual Health (SWASH) survey has run biennially since 1996 as a collaboration of ACON Health and researchers at local universities. We conducted a sub-analysis to a) identify the major risk behaviors and health issues for young lesbian, bisexual and queer identified women, and b) combine lifestyle and community engagement data to guide targeted health promotion for these groups. To explore these aims we used 379 completed SWASH surveys from women aged 17-30 years attending 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. Sexual behaviour is irrelevant for the majority of health disparities affecting young sexual minority women. Meaningful engagement with contemporary self-selected sexual identities - and their local social and cultural significance - is essential for the development of appropriate and effective targeted public health interventions.