Rankow E J, Tessaro I
Cancer Prevention, Detection and Control Research, Duke University Medical Center, Durham, North Carolina, USA.
J Fam Pract. 1998 Aug;47(2):139-43.
Previous studies of lesbian and bisexual women have suggested that negative experiences with health care practitioners, combined with misinformation about the health needs of this diverse population, have led to an underutilization of medical services.
This study combined focus group data (N = 44) with a self-administered questionnaire (N = 57) to explore the health concerns of lesbian women, including the prevalence of risk factors for cervical cancer, the frequency of Papanicolaou (Pap) test screening, and the barriers to obtaining care. We examined the influence of women's perceptions regarding the knowledge and sensitivity of their clinicians to lesbian issues and their experiences of discrimination in the medical setting of Pap test utilization.
Respondents reported risk factors for cervical cancer, including multiple past or current sexual partners (both male and female), early age at first coitus, history of sexually transmitted diseases, and cigarette smoking. One forth of respondents had not had a Pap test within the last 3 years, including 39 (7.6%) who had never had a Pap test. Women who reported that their health care providers were more knowledgeable and sensitive to lesbians issues were significantly more likely to have had a Pap test within the last year, even when controlling for age, education, income, and insurance status.
Lesbian women are at risk for cervical cancer and should receive routine cytologic screening according to individual risk assessment. The quality of clinician-patient interactions strongly influences care-seeking within the population sampled.
先前针对女同性恋和双性恋女性的研究表明，她们在医疗保健从业者那里遭遇的负面经历，再加上对这一多样化人群健康需求的错误信息，导致了医疗服务利用不足。
本研究将焦点小组数据（N = 44）与一份自填式问卷（N = 57）相结合，以探究女同性恋女性的健康问题，包括宫颈癌危险因素的患病率、巴氏试验筛查的频率以及获得护理的障碍。我们考察了女性对临床医生在女同性恋问题方面的知识和敏感度的认知，以及她们在巴氏试验利用的医疗环境中的歧视经历所产生的影响。
受访者报告了宫颈癌的危险因素，包括过去或当前有多个性伴侣（包括男性和女性）、初次性交年龄早、性传播疾病史以及吸烟。四分之一的受访者在过去3年内未进行过巴氏试验，其中39人（7.6%）从未进行过巴氏试验。那些报告称其医疗保健提供者对女同性恋问题更了解且更敏感的女性，即使在控制了年龄、教育程度、收入和保险状况后，在过去一年中进行巴氏试验的可能性也显著更高。
女同性恋女性有患宫颈癌的风险，应根据个体风险评估接受常规细胞学筛查。临床医生与患者互动的质量在抽样人群中对寻求医疗护理有强烈影响。
