Introduction Access and host are essential in order to satisfactorily intervene in the population health and the Brazilian literature has few studies approaching the access to services and sexual and reproductive care among women who have sex with women (WSW). The aim of this study was to analyse the access to health services and sexual and reproductive health care of WSW in public health policies.

Methods Cross-sectional, descriptive and analytical study. The data were obtained by interview, gynaecological and blood laboratory examination for sexually transmitted infections (STI) diagnosis, from January 2015 to December 2016.The descriptive statistics and the quantitative method of Bardin were used to analyse the access to health services. Sexual and reproductive health care was analysed by linear and multiple regression models.

Results The intentional sample was 149 WSW and the median age was 27 years-old (18-62). There was a predominance of white women (74.5%), non-union (73.2%), who had paid activity (73.2%) and eight years or more of completed study (96,0%).The majority (84.0%) used the public health service, 22.6% sought preventive actions. The difficulties encountered in the health services care were reported by 77 women, resulted in 118 responses with 28.8% associated with difficulty by long waiting time and 7.6% by lack of preparation of the professional/service for MSM.Regarding sexual and reproductive care, 71.8% had sexual intercourse after consumption of alcohol and/or illicit drugs, 12.1% did not use a condom and 51.7% had at least one STI. Age was a factor associated with the care score (p=0.001, β=1.36 CI=0.57–2.15) and no differences were observed in the MSM health care score with a history of sexual intercourse with men compared to those who only had women.

Conclusion Beside the difficulties of access to health services already experienced by women in general, there is a high programmatic in addition to individual and social vulnerability. This study indicates the need for effective strategies for the proposed policies for WSW.