(P182) Sexual health and sexually transmitted infections prevention among people who have sex between vulvas: a Brazilian analysis

Background: Sexual health and prevention of sexually transmitted infections (STI) for people who have sex between vulvas (PSBV) are often invisible to the eyes of healthcare professionals, educators, and science. The overall perception of invulnerability to STI is usually higher for PSBV who never have sex with people with penises. Consequently, this population may be at higher risk for detrimental health outcomes.

Methods: We used a self-completion electronic survey to obtain data concerning perceptions, attitudes, and practices of sexual health and STI prevention among people who have SBV in Brazil. Participants reporting sexual activity with other people with vulvas exclusively were defined as PSBVE (PSBV exclusive); those reporting also having sexual activity with people with penises were defined as PSBVP (PSBV and penises).

Results: We included 1508 participants ≥18 years old between October-2022 and January-2023. Most were white/caucasians (70%), and most (62%) had per capita income >2 minimum wages. 83% were cisgender women, 10% transgender men, and 7% non-binary/queer. 53% were PSBVE and 47% were PSBVP. The median number of sexual partners in the past year was 3.3 for PSBVE and 6.4 for PSBVP. A prior diagnosis of any STI or bacterial vaginosis/candidiasis was more frequently reported by PSBVP; conversely, PSBVE had less often been tested with STI serologies and pap smears (TABLE 1). Vaccination for hepatitis B was reported by 75% among PSBVE and 76% among PSBVP; vaccination for HPV was reported by 41% among PSBVE and 46% among PSBVP. 70% of PSBVE and 77% of PSBPP reported a routine visit to a gynecologist in the past year. Overall, 44% reported stigmatizing attitudes from a healthcare provider; examples of discriminatory/misleading phrases heard in health services included "there is no risk for STI if there's no penetration"; "if you only have sex with women, you are a virgin".



Conclusions: Several aspects of sexual health services offered to PSBV could be improved, and PSBVE had lower access to gynecological care and STI prevention strategies compared to PSBVP. These findings reflect the overall low awareness about the vulnerabilities of PSBV, and PSBVE in particular, to STI.