Bacterial vaginosis is a common vaginal infection, causing an abnormal vaginal discharge and/or odour in up to 50% of sufferers. Recurrence is common following recommended treatment. There are limited data on women’s experience of bacterial vaginosis, and the impact on their self-esteem, sexual relationships and quality of life. The aim of this study was to explore the experiences and impact of recurrent bacterial vaginosis on women. A social constructionist approach was chosen as the framework for the study. Thirty five women with male and/or female partners participated in semi-structured interviews face-to-face or by telephone about their experience of recurrent bacterial vaginosis. Recurrent bacterial vaginosis impacted on women to varying degrees, with some women reporting it had little impact on their lives but most reporting it had a moderate to severe impact. The degree to which it impacted on women physically, emotionally, sexually and socially often depended on the frequency of episodes and severity of symptoms. Women commonly reported that symptoms of bacterial vaginosis made them feel embarrassed, ashamed, ‘dirty’ and very concerned others may detect their malodour and abnormal discharge. The biggest impact of recurrent bacterial vaginosis was on women’s self-esteem and sex lives, with women regularly avoiding sexual activity, in particular oral sex, as they were too embarrassed and self-conscious of their symptoms to engage in these activities. Women often felt confused about why they were experiencing recurrent bacterial vaginosis and frustrated at their lack of control over recurrence. Women’s experience of recurrent bacterial vaginosis varied broadly and significantly in this study. Some women reported little impact on their lives but most reported a moderate to severe impact, mainly on their self-esteem and sex life. Further support and acknowledgement of these impacts are required when managing women with recurrent bacterial vaginosis.

Despite recent evidence demonstrating that lesbian and bisexual women are at risk of sexually transmitted infections (STIs), there is a common perception that STIs cannot be transmitted between women. This paper reports on a study in which a self‐report questionnaire, completed by over 300 lesbian and bisexual women and a comparison group of heterosexual women, was undertaken to determine lesbian and bisexual women's levels of knowledge about the human papillomavirus (HPV) and their attitudes toward the HPV vaccine and cervical smear testing. Alongside this, a series of in‐depth interviews with lesbian and bisexual women explored how they perceive their level of HPV risk, the reasons why they do or do not feel at risk and how they manage their sexual health in relation to their lesbian or bisexual identity. The study concludes that lesbians generally feel at low risk for STIs because they are excluded from dominant sexual scripts that inform the negotiation of safer sex practice. Lesbians are unlikely to engage with sexual health promotion targeted toward gay men or heterosexual women, yet lesbian‐specific sexual health promotion does not adequately construct an alternate discourse on safer sex that lesbians can relate to their own sexual practice.

We assessed whether existing guidelines for the primary care of lesbian, gay, and bisexual (LGB) people meet appropriate standards of developmental rigor, and whether they provide consistent recommendations useful for primary care clinicians. We performed a systematic review of such guidelines using the Cochrane Collaboration method. The countries searched were Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States. For sources, we used electronic databases, guidelines databases, primary care professional organizations, government departments of public health, LGB health care textbooks, and national LGB organizations. We assessed the quality of existing guidelines using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) instrument and compared the recommendations from all fully appraised guidelines. Our search did not identify any previous systematic reviews on primary care of LGB people. Of 2,421 documents identified, we initially reviewed 30 and fully appraised 11, none of which completely satisfied the AGREE criteria for quality and only 2 of which were specifically designed for primary care. Developmental rigor was poor. Particular gaps were a lack of explicit inclusion criteria, independent reviewers, and updating procedures. Nonetheless, we did identify several consistent recommendations pertinent to primary care settings: guidance on inclusive clinical environments, standards for clinician-patient communication, sensitive documentation of sexual orientation, knowledge for cultural awareness, staff training, and addressing population health issues. Currently available guidelines for LGB care are philosophically and practically consistent, and provide a degree of evidence-based clinical and systems support to primary care clinicians. There is a need, however, for evidence-based LGB guidelines that are more rigorously developed, disseminated, and evaluated specifically for the primary care setting.