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This study estimates risk ratios for the association between two dimensions of sexual orientation (sexual identity and sexual behavior) and five sexual and reproductive health indicators (pregnancy, contraceptive use, human immunodeficiency virus [HIV] testing, Pap test use, and sexual assault) among African American sexual minority women in the U.S. South. The results confirm that several sexual and reproductive health indicators varied in relation to sexual identity and sexual behavior among Southern African American sexual minority women.