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Are women-who-have-sex-with-women an ‘at-risk’ group for cervical cancer? An exploratory study of women in Aotearoa New Zealand

Sonja J. Ellis A *
+ Author Affiliations
- Author Affiliations

A The University of Waikato, Te Whare Wānanga o Waikato, Hamilton 3240, New Zealand.

* Correspondence to:

Handling Editor: Julia Brotherton

Sexual Health 21, SH23145
Submitted: 3 August 2023  Accepted: 14 November 2023  Published: 4 December 2023

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)



International research consistently indicates that women-who-have-sex-with-women (WSW) are less likely to engage in cervical screening than heterosexual women. In the main, studies have explored rates of engagement and highlighted some reasons for non-engagement. This study extends on this work by exploring perceptions among sexual minority women (WSW) for lower rates of engagement among WSW more generally and is the first study on this topic undertaken in Aotearoa New Zealand.


A sample of 177 self-identified WSW domiciled in New Zealand completed an online survey about their engagement in cervical screening, reasons for engaging (or not) in cervical screening, and perceptions of why SMW might be less likely to engage in cervical screening.


Fewer than half of participants had engaged in cervical screening every 3 years as recommended, with women who had only ever had sex with other women being significantly less likely to have engaged in screening. A lack of clear information about risk relative to sexual history, heteronormativity, and the invasive nature of screening were the dominant reasons for lower engagement among WSW.


A legacy of misinformation, and endemic heteronormativity in public health messaging around cervical screening is a significant barrier to engagement in screening for WSW. To increase engagement in screening among WSW, public health information needs to specifically address the needs of WSW.

Keywords: cervical cancer prevention, cervical cancer risk, cervical screening, health education, lesbians, New Zealand, sexual health, sexual minority women.


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