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

Abstract

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.

Factors associated with human papillomavirus (HPV) test acceptability in primary screening for cervical cancer: A mixed methods research synthesis

“…The study selection flow diagram is presented in Figure 2. We retained 22 primary studies: 5 of qualitative methodology [29][30][31][32][33], 15 of quantitative methodology [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] and 2 in which both methodologies were used [49,50]. Seventeen studies originate in high income countries (8-USA, 2-Canada, 5-Europe and 2 in Australia) and five in low and middle income countries (1-Mexico, 1-El Salvador, 1-China, 1-India and 1 in Nigeria).…”

“…General health status [37,39], history of abnormal Pap test [38,40,48], past medical history e.g., cancer [36,39], cardiovascular disease, diabetes, depression [36], history of STI's [35,36] are grouped under personal medical history and health status. Having a family member with cervical or other malignancies [32,36,39,40] is grouped under family medical history.…”

Establishing Effective Health Care Partnerships with Sexual and Gender Minority Patients: Recommendations for Obstetrician Gynecologists

“…Surveys collecting data on the three components of sexual orientation consistently show small percentages of respondents self-identifying their sexual orientation in a manner that does not align with their sexual behavior. [39][40][41] Finally, it is important to understand that sexual attraction, behavior, and identity can shift throughout the life course.…”

Le suivi gynécologique des femmes ayant des rapports sexuels avec des femmes : déterminants, enjeux, perspectives

“…L'immense majorité des participantes ne connaît pas son statut sérologique en s'engageant dans des rapports sexuels avec une femme, et ne connaît pas celui de ses partenaires (une enquêtée a déclaré avoir vu les résultats du dépistage d'une compagne).On constate que les femmes ayant des rapports sexuels avec des femmes « ne se sont pas glissées dans le moule du dépistage et de la prévention »(66). Une récente étude américaine a montré que les femmes s'identifiant comme lesbiennes se faisaient significativement moins dépister pour les IST que les femmes hétérosexuelles, après ajustement sur plusieurs variables(85).Outre l'absence de protection dans les rapports homosexuels, des participantes ont également rapporté une protection aléatoire dans les rapports hétérosexuels. Par ailleurs, sur 23 participantes dont les partenaires féminines avaient eu plusieurs relations, 19 ont déclaré qu'au moins une des Femme partenaires avait eu des rapports sexuels avec un homme ; aucune ne savait si ces relations avaient été protégées.Le fait de se présenter comme lesbienne ne limitant pas l'espace des possibles dans le domaine des comportements sexuels, la question des risques de transmission et des moyens de prévention des IST lors de rapports hétérosexuels et homosexuels devrait être plus souvent abordée par les professionnelLEs.…”