Agénor Madina, Austin S Bryn, Kort Daniel, Austin Erika L, Muzny Christina A
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Womens Health Issues. 2016 Nov-Dec;26(6):612-621. doi: 10.1016/j.whi.2016.07.004. Epub 2016 Aug 18.
Research on the sexual and reproductive health of sexual minority women, especially those of color, is limited.
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, human immunodeficiency virus [HIV] testing, Pap test use, and sexual assault) among African American sexual minority women in the U.S. South (n = 165).
Lesbians were less likely than bisexual women to have ever been pregnant (risk ratio [RR], 0.64; 95% confidence interval [CI], 0.48-0.85), ever received an HIV test (RR, 0.88; 95% CI, 0.80-0.96), obtained a Pap test in the last 3 years (RR, 0.75; 95% CI, 0.61-0.91), and had an abnormal Pap test result in their lifetime (RR, 0.42; 95% CI, 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 (RR, 0.58; 95% CI, 0.43-0.78), ever received an HIV test (RR, 0.87; 95% CI, 0.79-0.96), obtained a Pap test in the last 3 years (RR, 0.82; 95% CI, 0.67-0.99), and had an abnormal Pap test result in their lifetime (RR, 0.55; 95% CI, 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.
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.
关于性少数群体女性，尤其是有色人种性少数群体女性的性与生殖健康的研究有限。
我们使用多变量泊松回归，估计了美国南部非裔性少数群体女性（n = 165）中性取向的两个维度（性身份和性行为）与五个性与生殖健康指标（怀孕、避孕措施使用、艾滋病毒检测、巴氏试验检查以及性侵犯）之间关联的风险比。
女同性恋者比双性恋女性怀孕的可能性更低（风险比[RR]，0.64；95%置信区间[CI]，0.48 - 0.85），接受艾滋病毒检测的可能性更低（RR，0.88；95% CI，0.80 - 0.96），在过去3年接受巴氏试验检查的可能性更低（RR，0.75；95% CI，0.61 - 0.91），一生中巴氏试验结果异常的可能性更低（RR，0.42；95% CI，0.24 - 0.75）。过去一年只有女性性伴侣的女性比过去一年有男性和女性性伴侣的女性怀孕的可能性更低（RR，0.58；95% CI，0.43 - 0.78），接受艾滋病毒检测的可能性更低（RR，0.87；95% CI，0.79 - 0.96），在过去3年接受巴氏试验检查的可能性更低（RR，0.82；95% CI，0.67 - 0.99），一生中巴氏试验结果异常的可能性更低（RR，0.55；95% CI，0.32 - 0.94）。避孕措施的使用、在研究访视时巴氏试验结果异常以及遭受性侵犯在性身份或性行为方面没有差异。
在美国南部非裔性少数群体女性中，几个性与生殖健康指标在性身份和性行为方面存在差异。需要开展干预措施，以便更容易获得性与生殖健康服务，并针对性少数群体女性性取向亚组的独特需求进行调整。
