Agénor Madina, Bailey Zinzi, Krieger Nancy, Austin S Bryn, Gottlieb Barbara R
a Department of Social and Behavioral Sciences , Harvard T. H. Chan School of Public Health , Boston , Massachusetts , USA.
Women Health. 2015;55(6):717-36. doi: 10.1080/03630242.2015.1039182. Epub 2015 Apr 24.
Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, focus group discussions were conducted in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, the authors enrolled 18 black LBQ women who participated in one of four focus groups. Using thematic analysis, patient-provider communication was identified, which consisted of four sub-themes--health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and sociodemographic background--as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women's health care, and increasing the presence of LBQ women of color in health care settings.
很少有研究关注美国黑人女同性恋、双性恋和酷儿(LBQ)女性的健康与医疗保健情况。为了解该人群宫颈癌筛查的促进因素和障碍,2012年11月至12月期间在马萨诸塞州的波士顿和剑桥开展了焦点小组讨论。作者采用目的抽样方法,招募了18名黑人LBQ女性,她们参与了四个焦点小组中的一个。通过主题分析,确定了医患沟通是最突出的主题,它由四个子主题组成——医疗保健提供者的沟通风格和态度;异性规范提供者的假设;异性恋主义、种族主义和阶级主义;以及提供者的专业和社会人口背景。参与者报告了对多种形式歧视的恐惧和经历,并倾向于接受来自了解同性性健康且能分享其在性别、种族/族裔和性取向交叉点上生活经历的提供者的护理。通过对所有医疗保健提供者进行同性性健康培训、为临床医生提供了解各种形式歧视对女性医疗保健影响的机会,以及增加有色人种LBQ女性在医疗保健场所的比例,可以改善黑人LBQ女性的宫颈癌筛查体验。