Solazzo Alexa L, Tabaac Ari R, Agénor Madina, Austin S Bryn, Charlton Brittany M
Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States of America; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave, Boston, MA 02115, United States of America.
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave, Boston, MA 02115, United States of America; Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States of America.
Prev Med. 2019 Sep;126:105787. doi: 10.1016/j.ypmed.2019.105787. Epub 2019 Jul 30.
The human papillomavirus (HPV) vaccination, sexually transmitted infection (STI) tests, and Papanicolaou (Pap) testing rates vary by sexual orientation, which may be due in part to healthcare providers (HCP) recommending this care unevenly. Data (N = 17,675) came from the Growing Up Today Study (GUTS) (N = 8039) and Nurses' Health Study 3 (NHS3) (N = 9636). Among participants who met clinical guidelines to receive the care in question, we estimated the probability of an HCP encouraging participants to have the HPV vaccination, STI tests, or Pap test. Regardless of sexual orientation, participants whose HCP knew their sexual orientation were more likely to have been encouraged to get care compared to those whose HCP did not know the participant's sexual orientation. Sexual minority men and women were more likely to be encouraged to obtain HPV vaccination, STI tests, and Pap test than same-gender, completely heterosexuals with no same-sex partners, with some variation by gender and the care in question. Lesbian women were the sole sexual orientation subgroup that was less likely to be encouraged to receive care (HPV vaccination and Pap test) than their same gender, completely heterosexual counterparts with no same-sex partners (odds ratio [95% confidence interval]: 0.90 [0.80-1.00] and 0.94 [0.91-0.98], respectively). The differences across sexual orientation in HCPs' encouragement of care indicate a possible explanation for differences in utilization across sexual orientation. Across the US, HCPs under-encourage HPV vaccination, STI tests, and Pap test for all sexual orientation groups. Lesbian patients appear to be at high risk of under-encouragement for the Pap test.
人乳头瘤病毒（HPV）疫苗接种率、性传播感染（STI）检测率和巴氏（Pap）检测率因性取向而异，这可能部分归因于医疗服务提供者（HCP）对这类医疗服务的推荐不均衡。数据（N = 17675）来自“今日成长研究”（GUTS，N = 8039）和“护士健康研究3”（NHS3，N = 9636）。在符合临床指南接受相关医疗服务的参与者中，我们估算了医疗服务提供者鼓励参与者进行HPV疫苗接种、STI检测或Pap检测的概率。无论性取向如何，与医疗服务提供者不了解其性取向的参与者相比，医疗服务提供者了解其性取向的参与者更有可能受到鼓励去接受相关医疗服务。与没有同性伴侣的同性、完全异性恋者相比，性少数群体中的男性和女性更有可能受到鼓励去进行HPV疫苗接种、STI检测和Pap检测，不过在性别和相关医疗服务方面存在一些差异。女同性恋者是唯一一个比没有同性伴侣的同性、完全异性恋者更不容易受到鼓励去接受医疗服务（HPV疫苗接种和Pap检测）的性取向亚组（优势比[95%置信区间]：分别为0.90[0.80 - 1.00]和0.94[0.91 - 0.98]）。医疗服务提供者在鼓励接受医疗服务方面存在的性取向差异，可能解释了不同性取向在医疗服务利用率上存在差异的原因。在美国各地，医疗服务提供者对所有性取向群体的HPV疫苗接种、STI检测和Pap检测的鼓励都不足。女同性恋患者在Pap检测方面似乎面临着鼓励不足的高风险。
