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. 2006 Sep;83(5):970-9.
doi: 10.1007/s11524-006-9096-8.

Health care access and utilization among women who have sex with women: sexual behavior and identity

Bonnie D Kerker  1 , Farzad Mostashari, Lorna Thorpe
Affiliations

Health care access and utilization among women who have sex with women: sexual behavior and identity

Bonnie D Kerker et al. J Urban Health. 2006 Sep.

Abstract

Past research has shown that women who either have sex with women or who identify as lesbian access less preventive health care than other women. However, previous studies have generally relied on convenience samples and have not examined the multiple associations of sexual identity, behavior and health care access/utilization. Unlike other studies, we used a multi-lingual population-based survey in New York City to examine the use of Pap tests and mammograms, as well as health care coverage and the use of primary care providers, among women who have sex with women and by sexual identity status. We found that women who had sex with women (WSW) were less likely to have had a Pap test in the past 3 years (66 vs. 80%, p<0.0001) or a mammogram in the past 2 years (53 vs. 73%, p=0.0009) than other women. After adjusting for health insurance coverage and other factors, WSW were ten times [adjusted odds ratio (AOR), 9.8, 95% confidence interval (CI), 4.2, 22.9] and four times (AOR, 4.0, 95% CI 1.3, 12.0) more likely than non-WSW to not have received a timely Pap test or mammogram, respectively. Women whose behavior and identity were concordant were more likely to access Pap tests and mammograms than those whose behavior and identity were discordant. For example, WSW who identified as lesbians were more likely to have received timely Pap tests (97 vs. 48%, p<0.0001) and mammograms (86 vs. 42%, p=0.0007) than those who identified as heterosexual. Given the current screening recommendations for Pap tests and mammograms, provider counseling and public health messages should be inclusive of women who have sex with women, including those who have sex with women but identify as heterosexual.

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Figures

Figure 1
Figure 1
Distribution of health care access and utilization indicators among women who had sex with women and non-WSW (ages 18–64), New York City 2002 and 2004.
Figure 2
Figure 2
Adjusted odds ratios*—women who had sex with women compared to non-WSW (ages 18–64), New York City 2004.
See this image and copyright information in PMC

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References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S1049-3867(00)00070-0', 'is_inner': False, 'url': 'https://doi.org/10.1016/s1049-3867(00)00070-0'}, {'type': 'PubMed', 'value': '11275516', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11275516/'}]}
    2. Bradford J, White J, Honnold J, Ryan C, Rothblum E. Improving the accuracy of identifying lesbians for telephone surveys about health. Women's Health Issues. 2001;11(2):126–137. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '12734037', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12734037/'}]}
    2. Hughes TL, Jacobson KM. Sexual orientation and women's smoking. Current Women's Health Reports. 2003;2:254–261. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/archfami.9.9.843', 'is_inner': False, 'url': 'https://doi.org/10.1001/archfami.9.9.843'}, {'type': 'PubMed', 'value': '11031391', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11031391/'}]}
    2. Valanis BG, Bowen DJ, Bassford T, Whitlock E, Charney P, Carter RA. Sexual orientation and health. Arch Fam Med. 2000;9:843–853. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PMC', 'value': 'PMC1446477', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC1446477/'}, {'type': 'PubMed', 'value': '11392943', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11392943/'}]}
    2. Aaron DJ, Markovic N, Danielson ME, Honnold JA, Janosky JE, Schmidt NJ. Behavioral risk factors for disease and preventive health practices among lesbians. Am J Public Health. 2001;91:972–975. - PMC - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '12797855', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12797855/'}]}
    2. McNair RP. Lesbian health inequalities: a cultural minority issue for health professionals. Med J Aust. 2003;178:643–645. - PubMed

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