Sexual Health STDs HPV The Facts About HPV Risk in Lesbians By Lisa Fayed Lisa Fayed Lisa Fayed is a freelance medical writer, cancer educator and patient advocate. Learn about our editorial process Updated on April 13, 2020 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Anita Sadaty, MD Medically reviewed by Anita Sadaty, MD Facebook LinkedIn Twitter Anita Sadaty, MD, is a board-certified obstetrician-gynecologist at North Shore University Hospital and founder of Redefining Health Medical. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents How HPV Is Spread Reduce the Risk of HPV How to Find Out if You Have HPV Diseases Caused by HPV Strains Vaccinating Against HPV Lesbians have the lowest risk of getting human immunodeficiency virus (HIV) due in large part to the types of sexual activities they engage in (such as oral sex), which are less commonly associated with the infection. However, that does not mean that lesbians are, in general, less susceptible to other types of sexually transmitted infections (STIs). One example is human papillomavirus (HPV), known for its link to the development of cervical cancer. Not only do sexual minority people with vaginas often believe they are at less risk for HPV than heterosexual people with vaginas, but they may be less likely to receive preventive care such as vaccination and screening. Webphotographeer / Getty Images How HPV Is Spread A key difference between HIV and HPV is that the risk of HIV is strongly associated with penetrative sex. Penile penetration is not required to spread HPV; all it takes is skin-to-skin contact with an infected person. The virus can be transmitted through intimate skin-to-skin contact, such as mutual masturbation (an activity that carries a negligible risk of spreading HIV). HPV can be passed between two people with vaginas as easily as between two people with penises or a person with a penis and a person with a vagina. The sexual practices with the greatest likelihood of transmitting HPV include: Genital-to-genital contactTouching the genitals of an infected partner and then your own Sharing unsanitized sex toys Some studies have also suggested that HPV can be passed through oral-vaginal contact (cunnilingus) or by deep kissing, although there is strong contention as to the reliability of the studies. Reduce the Risk of HPV Lesbians can reduce their risk of getting or spreading HPV by: Using external or internal condoms on sex toys if planning to share Using gloves (a finger cot) when touching genitals Limiting the number of sexual partners Remaining in a monogamous relationship Using dental dams if any lesions or warts around the genitals or anus are present Abstinence is also an option, though a person can still contract an STI even if they are not engaging in intercourse. How to Find Out if You Have HPV People with vaginas living with HPV often discover they have HPV during a routine Pap smear. The Pap smear is able to detect cervical changes caused by the virus, some of which can lead to cervical cancer. In some cases, a genital wart may be present (a symptom commonly associated with certain types of HPV). Having abnormalities in cervical tissue (dysplasia) does not mean you have cancer, or even that you will definitely get cancer. Only a handful of HPV strains are associated with cancer and even fewer cause genital warts. In most cases, HPV will resolve on its own without medical treatment. Current guidelines from the American Cancer Society recommend that all people with vaginas have their first Pap smear three years after starting sexual activity or by age 21—whichever comes first. There is a popular misconception among some that lesbians do not need Pap smears. This is entirely false. All people with vaginas need to have regular Pap screening, irrespective of sexual orientation. The HPV test is another way to detect HPV. Rather than checking for changes, the test looks for the presence of the virus in a cervical swab. The Pap and HPV tests can be performed at the same time. According to the American College of Obstetricians and Gynecologists (ACOG), people with vaginas who are 30 years of age and over should retest every three years. People with vaginas at higher risk (such as those with abnormal change on a previous test) may need to be tested more frequently. Diseases Caused by HPV Strains There are over 150 different strains of the HPV virus, 40 of which are considered the "genital type" and can be transmitted sexually. It is believed that almost every person who is sexually active will contract at least one form of HPV in their lifetime. The types of HPV of most concern are those that can cause genital warts and those that can lead to cancer. It's important to note that a type that can cause one may not cause the other. HPV 16 and 18 have been linked to 70% of all cervical cancer diagnoses. HPV 16 is the most common strain associated with head and neck cancers (another 20% are linked to HPV 31, 33, 34, 45, 52, and 58). Roughly 90% of genital warts outbreaks are caused by HPV 6 and 11. Vaccinating Against HPV For individuals between the ages of 9 and 26, immunizations are available which can protect against some of the higher risk HPV strains. Gardasil (approved in 2006) protects against HPV 6, 11, 16 and 18Cervarix (approved in 2009) protects against HPV 16 and 18Gardasil 9 (approved in 2014) protects against HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58 A Word From Verywell Lesbians are at as much risk for HPV as exclusively heterosexual people with vaginas. Don't presume that non-penetrative sex puts you at less risk for HPV. Ensure that you are routinely screened for the virus and that any changes in cervical tissue are closely monitored. By doing so, you can greatly increase your risk of cervical cancer, as well as other HPV-related malignancies. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 11 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gay Mens Health Crisis, Heath-Toby A, Deol A. HIV risk for lesbians, bisexuals and other women who have sex with women. (PDF; publication ID: 34540), Women’s Institute at GMHC. Centers for Disease Control and Prevention (CDC) National Information Network. Mcree AL, Katz ML, Paskett ED, Reiter PL. HPV vaccination among lesbian and bisexual women: Findings from a national survey of young adults. Vaccine. 2014;32(37):4736-4742. doi:10.1016/j.vaccine.2014.07.001 Madison Clinic. Preventing HIV transmission. D'souza G, Kluz N, Wentz A, et al. 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