Sexual Behaviors, Perception of Sexually Transmitted Infection Risk, and Practice of Safe Sex Among Southern African American Women Who Have Sex With Women

Muzny, Christina A.; Harbison, Hanne S.; Pembleton, Elizabeth; Austin, Erika L.

doi:10.1097/olq.0b013e31828caf34

Cited by 26 publications

(46 citation statements)

References 21 publications

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“…As emphasized above, all YSMW should discuss family planning, gynecological health, and HIV/STI prevention with their provider and should receive clinical guidance regarding HIV/STI and Pap testing, in addition to HPV vaccination referrals. The need for such counseling and care would benefit YSMW, who may benefit from a clearer understanding of health risks associated with engaging in sexual relationships with other women (Muzny, Harbison, Pembleton, & Austin, 2013). …”

Section: Discussionmentioning

confidence: 99%

Sexual Health Care Services Among Young Adult Sexual Minority Women

et al. 2017

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Young adult sexual minority women (YSMW) are at elevated risk for negative reproductive health outcomes, yet are less likely than heterosexual peers to utilize preventive health care. Medical and public health policy organizations advocate sexual orientation disclosure (“coming out”) to health care providers as a strategy for increasing service utilization among YSMW. Limited research explores relationships between disclosure and receipt of sexual health services. YSMW (N=285) ages 21–24 participated in an online survey assessing their health behaviors and care utilization. We employed multivariable logistic regression models to examine the association between receipt of sexual health services and sexual orientation disclosure to provider, after adjusting for sociodemographic covariates. Thirty-five percent of YSMW were out to their provider. Less than half the sample had received Pap screening or STI testing in the previous year; approximately 15% had received at least one dose of the HPV vaccination. Disclosure was associated with increased likelihood of Pap screening (OR=2.66, p<.001) and HPV vaccination (OR=4.30, p<.001), but was not significantly associated with STI testing. Promoting coming out to providers may be a promising approach to increase sexual health care use among YSMW. Future research should explore causal relationships between these factors.

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Section: Discussionmentioning

confidence: 99%

Sexual Health Care Services Among Young Adult Sexual Minority Women

et al. 2017

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“…Research suggests that sexual orientation can influence women’s sexual health care by shaping their knowledge of, attitudes toward, and access to sexual health information and services as well as health care providers’ communication about and recommendation of sexual health services based on their training (or lack thereof) and beliefs about SMW’s health (Muzny et al, 2013; Marrazzo et al, 2005; Marrazzo, 2005; Power et al, 2009; Richardson, 2000; Price et al, 1996; McNair et al, 2009; Lindley et al, 2012; Polek and Hardie, 2010; McNair, 2003a, 2003b; Hutchinson et al, 2006). Moreover, it is possible that health insurance status and access to health care, which differ based on sexual orientation and influence the use of preventive health services, may help explain sexual health care disparities related to sexual behavior and identity among U.S. women (Kerker et al, 2006; Solarz, 1999; Institute of Medicine, 2011; Gonzales and Blewett, 2014; Jerant et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Given the exclusion of SMW from sexual health promotion efforts and misperceptions, among both women and providers, that the risk of female-to-female STI transmission is low (Muzny et al, 2013; Marrazzo et al, 2005; Marrazzo, 2005; Power et al, 2009; Richardson, 2000; Price et al, 1996; McNair et al, 2009; Lindley et al, 2012; Polek and Hardie, 2010; McNair, 2003a, 2003b), it is critically important that researchers ascertain STI and HIV testing and cervical cancer screening disparities among women in relation to both sexual behavior and sexual identity and elucidate the underlying mechanisms of sexual orientation disparities in women’s sexual health care. These efforts will in turn help inform evidence-based interventions that facilitate access to and utilization of recommended sexual health services among underserved groups of SMW and help promote the sexual health of all women, regardless of sexual orientation.…”

Section: Introductionmentioning

confidence: 99%

Sexual orientation and sexual health services utilization among women in the United States

Agénor

Muzny

Schick

et al. 2017

Preventive Medicine

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Although sexual minority women are at risk of sexually transmitted infections (STIs) and cervical cancer, few nationally representative studies have assessed sexual orientation disparities in sexual health care among women. Using data from the 2011–2013 and 2013–2015 waves of the National Survey of Family Growth, which provide a national probability sample of U.S. women aged 15–44 years (N=11,300), we used multivariable logistic regression to examine the associations between sexual behavior and sexual identity (modeled separately) and STI testing in the past year, Pap test use in the last 3 years, lifetime HIV testing, and lifetime human papillomavirus (HPV) testing. Women with male and female lifetime sexual partners had higher adjusted odds of being tested for STIs ([odds ratio:] 1.61; [95% confidence interval:] 1.37–1.89), HIV (1.66; 1.29–2.14), and HPV (1.79; 1.41–2.25) and similar adjusted odds of obtaining a Pap test (0.98; 0.76–1.27) than women with only male lifetime sexual partners. Self-identified bisexual women had higher adjusted odds of obtaining an STI (1.43; 1.10–1.86) and HIV (1.69; 1.24–2.30) test but lower adjusted odds of obtaining a Pap test in the last 3 years (0.66; 0.47–0.93) than heterosexual-identified women. Women with only female lifetime sexual partners had lower adjusted odds of receiving an STI (0.14; 0.07–0.28) and Pap (0.10; 0.03–0.27) test than women with only male lifetime sexual partners. Results comparing self-identified lesbian and heterosexual women were similar. Health care facilities should monitor and address sexual orientation disparities in women’s sexual health care and ensure the provision of high-quality sexual health services to all women.

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“…In order to promote the sexual and reproductive health of sexual minority women, medical and nursing curricula should include evidence-based content on the risk and prevention of sexual assault, pregnancy, HIV and other STIs (including HPV), and cervical cancer in this population (McNair, 2003a; McNair, 2003b), while recognizing the diversity of sexual behaviors and sexual and reproductive health needs that exist among sexual minority women (Muzny et al, 2013). Further, healthcare providers should be aware that the majority of sexual minority women, including lesbians and women with only female sexual partners in the past year, have engaged in sexual activity with men (Diamant et al, 1999; Marrazzo & Stine, 2004; Muzny et al, 2011).…”

Section: Implications For Policy and Practicementioning

confidence: 99%

“…In recent years, a few researchers have investigated the prevalence and determinants of STIs (Muzny, Austin, Harbison, & Hook, 2014; Muzny, Harbison, Pembleton, & Austin, 2013; Muzny et al, 2015; Muzny, Kapil, Austin, Hook, & Geisler, 2014; Muzny, Sunesara, Martin, & Mena, 2011) and cervical cancer screening (Agénor, Bailey, Krieger, Austin, & Gottlieb, 2015; Agénor et al, 2014; Matthews et al, 2013; Mays et al, 2002) among black sexual minority women. However, to our knowledge, no study has assessed other aspects of sexual and reproductive health in this understudied and underserved population.…”

Section: Introductionmentioning

confidence: 99%

Sexual Orientation and Sexual and Reproductive Health among African American Sexual Minority Women in the U.S. South

Agénor

Austin

Kort

et al. 2016

Women's Health Issues

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Background Research on the sexual and reproductive health of sexual minority women, especially those of color, is limited. Methods Using multivariable Poisson regression, we estimated 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, HIV testing, Pap test use, and sexual assault) among African American sexual minority women in the U.S. South (N=165). Results Lesbians were less likely than bisexual women to have ever been pregnant ([risk ratio=] 0.64, [95% confidence interval=] 0.48-0.85), ever received an HIV test (0.88, 0.80-0.96), obtained a Pap test in the last three years (0.75, 0.61-0.91), and had an abnormal Pap test result in their lifetime (0.42, 0.24-0.75). Women with only female past-year sexual partners were less likely than women with male and female past-year sexual partners to have ever been pregnant (0.58, 0.43-0.78), ever received an HIV test (0.87, 0.79-0.96), obtained a Pap test in the last three years (0.82, 0.67-0.99), and had an abnormal Pap test result in their lifetime (0.55, 0.32-0.94). Contraceptive use, receiving an abnormal Pap test result at the time of the study visit, and experiencing sexual assault did not differ by sexual identity or behavior. Conclusions Several sexual and reproductive health indicators varied in relation to sexual identity and sexual behavior among Southern African American sexual minority women. Interventions that facilitate access to sexual and reproductive health services and are tailored to the unique needs of sexual orientation subgroups of sexual minority women are needed.

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Sexual Behaviors, Perception of Sexually Transmitted Infection Risk, and Practice of Safe Sex Among Southern African American Women Who Have Sex With Women

Cited by 26 publications

References 21 publications

Sexual Health Care Services Among Young Adult Sexual Minority Women

Sexual Health Care Services Among Young Adult Sexual Minority Women

Sexual orientation and sexual health services utilization among women in the United States

Sexual Orientation and Sexual and Reproductive Health among African American Sexual Minority Women in the U.S. South

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