Case of a Girl with Vaginal Discharge Who Has Sex with Girls
Adolescent women who have sex with women (WSW) and men (WSWM) are a unique group of girls with diverse sexual experiences. Despite having female sexual partners, these girls may be at increased risk for unplanned pregnancies and STIs as many WSW also have sex with men. Sexual histories for these girls should include gender neutral terms, open-ended questions, details of sexual behaviors, and gender of sexual partners. These histories should be conducted in a manner that facilitates honesty and trust while ensuring confidentiality. Heterosexuality should never be assumed. Problematic vaginal discharge from bacterial vaginosis and candida vulvovaginitis may be common complaints among these girls. Adolescent WSW should be offered routine chlamydia screening, HIV testing, and contraception counseling (including LARCs), encouraged to use barrier contraceptive methods, and screened for depression and intimate partner violence. Additionally, referrals to LGBTQ peer support groups may also be helpful in ensuring the wellbeing of these girls.
KeywordsWomen who have sex with women (WSW) Women who have sex with women and men (WSWM) Vaginal discharge Lesbian Bisexual Adolescent girls LGBTQ health
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