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Ertl MM, Maroney MR, Becker A, Paschen-Wolff MM, Blankenau A, Hoffman S, Tross S. Sexual and Reproductive Justice and Health Equity for LGBTQ+ Women. JOURNAL OF LESBIAN STUDIES 2024:1-29. [PMID: 38946155 DOI: 10.1080/10894160.2024.2369434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
LGBTQ+ women have long been overlooked in sexual and reproductive health research. However, recent research has established that LGBTQ+ women have unique and specific needs that need to be addressed in order to improve effectiveness of sexual health education and practice with this historically and presently underserved population. Informed by a reproductive justice framework coupled with liberation psychology theory, this review discusses the current state of sexual and reproductive health and technologies among LGBTQ+ women. In particular, we focus on a range of HIV prevention and reproductive technologies and their use and promotion, including the internal condom, abortion, oral contraceptives, dapivirine ring, HIV pre-exposure prophylaxis, intrauterine device, and other less studied options, such as the contraceptive sponge. Grounded in an intersectional framing, this review acknowledges the intersecting systems of oppression that affect multiply marginalized women inequitably and disproportionately. A sociohistorical, critical lens is applied to acknowledge the well-documented racist origins of reproductive health technologies and ongoing coercive practices that have led to medical mistrust among marginalized and stigmatized communities, particularly racialized LGBTQ+ women, women with disabilities, and women who are poor or incarcerated. Moreover, we discuss the urgent need to center LGBTQ+ women in research and clinical care, community-engaged health promotion efforts, affirming non-heteronormative sexual health education, and health policies that prioritize autonomy and dismantle structural barriers for this population. We conclude with recommendations and future directions in this area to remedy entrenched disparities in health.
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Affiliation(s)
- Melissa M Ertl
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Meredith R Maroney
- Department of Counseling and School Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Andréa Becker
- Department of Sociology, Hunter College, New York, NY, USA
| | - Margaret M Paschen-Wolff
- Department of Psychiatry, Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Amelia Blankenau
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Susie Hoffman
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Susan Tross
- Department of Psychiatry, Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, New York, NY, USA
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2
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Wesche R, Toman M, Grafsky EL, Gupta S, Tarantino MR. Developing an Inclusive Model of Young Heterosexual and Sexual Minority Women's Sexual Decision-Making. JOURNAL OF SEX RESEARCH 2024:1-15. [PMID: 38687300 DOI: 10.1080/00224499.2024.2320260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Efforts to improve sexual health outcomes among young cisgender women require in-depth understanding of how women with diverse sexual identities make decisions about their sexual health. We conducted semi-structured interviews with 31 young cisgender women with diverse sexual identities and histories (age range 18-29 (M = 23.32); 81% White; 29% bisexual, 26% heterosexual, 16% lesbian, 13% queer, 10% pansexual, 3% gay, 3% demisexual) about their decision-making surrounding sexual risk reduction. By conducting thematic analysis, we found that, regardless of partner sex or gender, women adapted sexual health strategies based on how much commitment, trust, and communication existed in their relationships. Because heteronormative structural influences limited access to information and safer sex options, women had to rely on trust and communication more with other women and partners with vaginas, compared to men and partners with penises. Women did not consider safer sex strategies with partners with vaginas (e.g. hand washing) risk-reduction techniques; instead, they considered them general hygiene or a way to take care of a partner. We propose that an inclusive model of young women's sexual decision-making should: (a) highlight the influence of relationships; (b) frame prevention in terms of overall health instead of pregnancy and STIs; and (c) acknowledge that structural factors, such as heteronormativity and sex-negativity, constrain women's decisions.
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Affiliation(s)
- Rose Wesche
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Madelyn Toman
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Erika L Grafsky
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Shivangi Gupta
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
| | - Mari R Tarantino
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University
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Al Sad S, Pandit R, Alhashim N, Abdel-Rasoul M. Primary care Providers' approaches to cervical cancer screening in Muslim females. Prev Med Rep 2023; 32:102126. [PMID: 36852309 PMCID: PMC9958399 DOI: 10.1016/j.pmedr.2023.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/07/2023] Open
Abstract
The utilization of the Papanicolaou (Pap) test and the human papillomavirus (HPV) vaccine has significantly decreased rates of cervical cancer and related mortality. Disparities in receiving these preventive screenings are scarcely studied in Muslim females. Our study explores primary care providers' (PCP) approaches to cervical cancer screening in Muslim females. We created a cross-sectional Qualtrics survey using convenience sampling of PCPs who perform Pap tests in central Ohio. Recruitment emails were disseminated via departmental email listservs. We had 200 analyzable responses and 78% of respondents reported having Muslim patients. Bivariate analysis was used to identify predictors of providers' approaches. Providers younger than 35 years obtained a sexual history from Muslim females less frequently, family medicine providers were more likely to obtain a sexual history from Muslim females, and gynecologists were more likely to offer the HPV vaccine to Muslim females. Providers who counseled patients about Pap tests (P<0.001) and HPV modes of transmission (P<0.004) were more likely to offer cervical cancer screening for Muslim females. Our findings suggested that providers' age and specialty may be predictors of proactive cervical cancer screening and prevention in Muslim females and that there is a gap between current guidelines and preventive clinical practices regarding the HPV vaccine and transmission counseling.
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Affiliation(s)
- Sondos Al Sad
- Women Health Primary Care Center, Family and Community Medicine Department, University of California San Francisco, 2356 Sutter St, San Francisco, CA 94115, USA,Corresponding author.
| | - Radhika Pandit
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, USA
| | | | - Mahmoud Abdel-Rasoul
- The Ohio State University College of Medicine, Center for Biostatistics, 1800 Cannon Drive Columbus, OH 43210, USA
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4
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Gil-Llario MD, Morell-Mengual V, García-Barba M, Nebot-García JE, Ballester-Arnal R. HIV and STI Prevention Among Spanish Women Who have Sex with Women: Factors Associated with Dental Dam and Condom Use. AIDS Behav 2023; 27:161-170. [PMID: 35788924 PMCID: PMC9852118 DOI: 10.1007/s10461-022-03752-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 01/24/2023]
Abstract
The scientific community has systematically ignored the needs of women who have sex with women (WSW). The invisibilization of romantic and sexual relationships between women has caused a profound lack of knowledge about the impact of HIV and other STIs on this population subgroup. This study aims to analyze the frequency of dental dam and condom use in WSW and identify the variables that explain the use of these two preventive methods. The sample is composed of 327 women aged between 18 and 60 years (M = 27.82; SD = 8.10). The results indicate that only 4.7% of those who practice cunnilingus and 5.2% of those who practice anilingus report "always" using dental dam (systematic use). Condoms are used systematically by 37.1% of those who practice vaginal penetration and 37.8% of those who practice anal penetration. Age, high perceived self-efficacy, and adequate assertive communication skills are variables significantly related to preventive behavior. The severity attributed to HIV and the perceived risk of infection are protective factors regarding dental dam use. For condom use, high levels of internalized homophobia and drug use are risk factors. Future preventive strategies should provide information on preventive strategies to WSW who, for different reasons, are not involved in LGBT contexts or associations and, therefore, do not have access to training activities and mistakenly believe that they are invulnerable as they do not have sexual relations with men.
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Affiliation(s)
- María Dolores Gil-Llario
- grid.5338.d0000 0001 2173 938XDepartment of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Vicente Morell-Mengual
- grid.5338.d0000 0001 2173 938XDepartment of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Marta García-Barba
- grid.9612.c0000 0001 1957 9153Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castelló de la Plana, Castellon Spain
| | - Juan E. Nebot-García
- grid.9612.c0000 0001 1957 9153Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castelló de la Plana, Castellon Spain
| | - Rafael Ballester-Arnal
- grid.9612.c0000 0001 1957 9153Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castelló de la Plana, Castellon Spain
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Saewyc EM, Lin C, Parrilla JS, Nath R, Ybarra ML. First time sexual experiences of sexual minority adolescent girls in the United States. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2022.2049631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Elizabeth M. Saewyc
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Chichun Lin
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Julia Santana Parrilla
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Ronita Nath
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Michele L. Ybarra
- Center for Innovative Public Health Research, Santa Ana, California, USA
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Gaps in sexual health research about women who have sex with women. A scoping review. GACETA SANITARIA 2022; 36:439-445. [DOI: 10.1016/j.gaceta.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/19/2022]
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Baker AM, Jahn JL, Tan AS, Katz-Wise SL, Viswanath K, Bishop RA, Agénor M. Sexual Health Information Sources, Needs, and Preferences of Young Adult Sexual Minority Cisgender Women and Non-Binary Individuals Assigned Female at Birth. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2021; 18:775-787. [PMID: 34484461 PMCID: PMC8414874 DOI: 10.1007/s13178-020-00501-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Young adult sexual minority women (SMW) have unique sexual health needs and higher rates of some poor sexual health outcomes compared to their heterosexual peers. Unequal access to relevant sexual health information may contribute to sexual orientation disparities in sexual health among women, but research on sexual health communication among SMW is sparse. METHODS In-depth interviews conducted in 2016-2017 investigated sexual health communication in a sample of 29 racially/ethnically diverse cisgender women and non-binary individuals assigned female at birth who were between 19 and 36 years of age and identified as a sexual minority. Data were analyzed using a thematic analysis approach that involved inductive and deductive coding to identify themes. RESULTS Three broad themes were identified: 1) sources of sexual health information; 2) sexual health information needs; and 3) preferences for sexual health information delivery. Participants discussed and critiqued the Internet, other mass media, health care providers, school-based sex education, family, and peers/partners as sources of sexual health information. Participants expressed a need for customized, non-heteronormative information pertaining to sexually transmitted infection risk and prevention. They preferred receiving information from health care providers, the Internet, and other mass media, and some also suggested school-based sex education and peer education as methods for delivering information. CONCLUSIONS Participants expressed clear desires for relevant, high-quality sexual health information delivered through a variety of channels, especially the Internet, other mass media, and health care providers. POLICY IMPLICATIONS Findings call for policies that improve provision of sexual health information through health care providers, online resources, and school-based sex education.
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Affiliation(s)
- Allison M. Baker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jaquelyn L. Jahn
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andy S.L. Tan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Sabra L. Katz-Wise
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rachel A. Bishop
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Executive Office of Health & Human Services, Commonwealth of Massachusetts, Boston, MA, USA
| | - Madina Agénor
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Community Health, Tufts University, Medford, MA, USA
- Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
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Tabaac AR, Haneuse S, Johns M, Tan AS, Austin SB, Potter J, Lindberg L, Charlton BM. Sexual and reproductive health information: Disparities across sexual orientation groups in two cohorts of U.S. women. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2021; 18:612-620. [PMID: 34484460 PMCID: PMC8414943 DOI: 10.1007/s13178-020-00485-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Limited research exists about how receiving/seeking sexual and reproductive health (SRH) information differs by sexual orientation. Our goal was to identify how sources and topics of SRH information differed by sexual orientation during adolescence in a sample of U.S. women. METHODS A sample of 8,541 U.S. women ages 22-35 years from two cohorts of the Growing Up Today Study completed a 2016 questionnaire measure about receiving/seeking SRH information before age 18 years. Adjusted log-linear models assessed differences in SRH information topics and sources by reported sexual orientation (completely heterosexual with no same-sex partners [reference]; completely heterosexual with same-sex partners; mostly heterosexual; bisexual; lesbian). RESULTS Compared to the referent, most sexual minority subgroups were more likely to receive/seek information from peers, media, and other sources (e.g., community centers). With the exception of lesbians, sexual minority subgroups were more likely to receive/seek information about contraception, and mostly heterosexual and bisexual women were more likely to receive information about sexually transmitted infections. Conclusions: Findings indicate women of diverse sexual orientations need access to SRH information from sources like schools, peers, and media. Sexual minority women receive/seek information about many SRH topics, which indicates that opportunities to tailor educational resources within and outside of schools are needed so SRH benefits to these populations are maximized. POLICY IMPLICATIONS Specifying sexual minority-sensitive educational materials in sex education policy can meet information needs and aid sexual minority women in making informed sexual health decisions.
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Affiliation(s)
- Ariella R. Tabaac
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA
- Center for Gender Surgery, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michelle Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Andy S.L. Tan
- Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research, Boston, MA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Jennifer Potter
- Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
- Fenway Institute, Boston, MA
| | | | - Brittany M. Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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Emetu R, Missari S, Hernandez E, Fuentes V. Correlates of sexual minority women's sexual behavior. Women Health 2021; 61:633-641. [PMID: 34365918 DOI: 10.1080/03630242.2021.1953209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Sexual minority women (SMW) experience sociocultural barriers to healthcare access and utilization. A common misconception is that SMW are at lower risk for sexually transmitted infections (STIs). Such stereotypes, coupled with prioritization of reproductive health care for heterosexual women and STI prevention for men, contribute to fewer STI testing and appropriate reproductive examinations for SMW. Thus, this study examined SMW's current sexual behaviors, protective mechanisms, and STI history. Data was collected 2018 and 2019 during a weekend festival. Utilizing the cross-sectional design, 90 surveys were completed. The findings indicated that 70% of respondents were not utilizing protective mechanisms for same-sex behaviors; 13% had never been tested for an STI; and of those tested, 1 in 4 were diagnosed with an STI in their lifetime. Participants that engaged in bisexual behaviors were more likely to engage in genital-to-genital repetitive contact (p < .05). SMW with higher education were more likely to be screened for STIs (p < .01). This study highlights the variation of sexual and testing behaviors that SMW exhibit. Safer sex information and STI testing aimed at SMW should be led by healthcare providers. Thus, a national training curriculum geared toward healthcare providers to promote culturally appropriate care is suggested.
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Affiliation(s)
- Roberta Emetu
- College of Health & Human Development, Department of Health Science, California State University, Northridge, CA, USA
| | - Stacy Missari
- College of Social & Behavioral Sciences, Department of Sociology, California State University, Northridge, CA, USA
| | - Emily Hernandez
- College of Social & Behavioral Sciences, Department of Psychology, California State University, Northridge, CA, USA
| | - Vannessa Fuentes
- College of Health & Human Development, Department of Health Science, California State University, Northridge, CA, USA
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10
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Ybarra M, Goodenow C, Rosario M, Saewyc E, Prescott T. An mHealth Intervention for Pregnancy Prevention for LGB Teens: An RCT. Pediatrics 2021; 147:e2020013607. [PMID: 33568491 PMCID: PMC7924142 DOI: 10.1542/peds.2020-013607] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although lesbian, gay, bisexual and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence, relevant pregnancy prevention programming is lacking. METHODS A national randomized controlled trial was conducted with 948 14- to 18-year-old cisgender LGB+ girls assigned to either Girl2Girl or an attention-matched control group. Participants were recruited on social media between January 2017 and January 2018 and enrolled over the telephone. Between 5 and 10 text messages were sent daily for 7 weeks. Both experimental arms ended with a 1-week booster delivered 12 weeks subsequently. RESULTS A total of 799 (84%) participants completed the intervention end survey. Participants were, on average, 16.1 years of age (SD: 1.2 years). Forty-three percent were minority race; 24% were Hispanic ethnicity. Fifteen percent lived in a rural area and 29% came from a low-income household. Girl2Girl was associated with significantly higher rates of condom-protected sex (adjusted odds ratio [aOR] = 1.48, P < .001), current use of birth control other than condoms (aOR = 1.60, P = .02), and intentions to use birth control among those not currently on birth control (aOR = 1.93, P = .001). Differences in pregnancy were clinically but not statistically significant (aOR = 0.43, P = .23). Abstinence (aOR = 0.82, P = .34), intentions to be abstinent (aOR = 0.95, P = .77), and intentions to use condoms (aOR = 1.09, P = .59) were similar by study arm. CONCLUSIONS Girl2Girl appears to be associated with increases in pregnancy preventive behaviors for LGB+ girls, at least in the short-term. Comprehensive text messaging-based interventions could be used more widely to promote adolescent sexual health behaviors across the United States.
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Affiliation(s)
- Michele Ybarra
- Center for Innovative Public Health Research, San Clemente, California
| | | | - Margaret Rosario
- City College and Graduate Center, The City University of New York, New York, New York; and
| | - Elizabeth Saewyc
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Tonya Prescott
- Center for Innovative Public Health Research, San Clemente, California
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Tabaac AR, Benotsch EG, Agénor M, Austin SB, Charlton BM. Use of media sources in seeking and receiving sexual health information during adolescence among adults of diverse sexual orientations in a US cohort. SEX EDUCATION 2021; 21:723-731. [PMID: 34899055 PMCID: PMC8659378 DOI: 10.1080/14681811.2021.1873122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/05/2021] [Indexed: 06/14/2023]
Abstract
The objective in this study was to examine the association between sexual orientation and seeking/receiving sexual and reproductive health (SRH) information from media sources during adolescence. We analysed data from male and female participants (aged 23-35 years) from the U.S.-based Growing Up Today Study (GUTS) in 2016. Sex-stratified, multivariable log-binomial models adjusted for age, cohort and race/ethnicity were used to examine sexual orientation differences in retrospective self-reported seeking/receipt of SRH media information before age 18. Sexual minority (e.g., mostly heterosexual, bisexual, gay) men and women were more likely than same-gender individuals who identified as completely heterosexual to seek/receive SRH information about contraceptive methods (e.g., condom use), sexually transmitted infections, and HIV and AIDS. Although lesbians were more likely than completely heterosexuals to seek/receive SRH information from media about each topic, they were the sexual minority subgroup with the smallest proportion seeking/receiving SRH information. Sexual minorities may passively and/or actively receive SRH information pertaining to a wide range of topics, including skills-based sex education, from media sources more frequently than heterosexuals, which may influence safe-sex decision-making. Lesbians in particular may benefit from media information dissemination focusing on their specific SRH needs, as current media sources do not seem to be well-utilised by this group.
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Affiliation(s)
- Ariella R. Tabaac
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Center for Gender Surgery, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Eric G. Benotsch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Madina Agénor
- Department of Community Health, Tufts University, Medford, MA, USA
- Department of Obstetrics/Gynecology, Tufts University School of Medicine, Boston, MA, USA
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Brittany M. Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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12
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Gordon AR, Calzo JP, Eiduson R, Sharp K, Silverstein S, Lopez E, Thomson K, Reisner SL. Asynchronous Online Focus Groups for Health Research: Case Study and Lessons Learned. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2021; 20:10.1177/1609406921990489. [PMID: 35185443 PMCID: PMC8856649 DOI: 10.1177/1609406921990489] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Increasingly, social life-and accordingly, social research-is conducted in online environments. Asynchronous online focus groups (AOFGs) have emerged as an important tool to conduct remote research with geographically diverse populations. However, there remain few systematic accounts of AOFG methods to guide researchers' decision-making in designing and implementing studies. This paper seeks to address this gap by describing a recent study on body image and health among transgender and gender diverse (TGD) young adults. In this study, eight AOFGs were conducted in August-October 2019 with 66 TGD young adults residing in 25 U.S. states. Each AOFG lasted four consecutive days with two prompts posted by moderators per day. Overall, participant satisfaction with AOFGs was high: 98% reported their experience was excellent, very good, or good and 95% would be somewhat or very likely to sign up for another AOFG. This example is used to illustrate key methodological decision-points, acceptability of the method to participants, and lessons learned. The goal of this paper is to encourage other researchers, particularly health researchers, to consider using AOFGs and to engage with the method's strengths and limitations in order to develop new opportunities for online technologies to enrich the field of qualitative health research.
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Affiliation(s)
- Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Division of Adolescent/Young Adults Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jerel P Calzo
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, CA, USA
| | - Rose Eiduson
- Division of Adolescent/Young Adults Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Kendall Sharp
- Division of Adolescent/Young Adults Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | | | - Katharine Thomson
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Sari L Reisner
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ybarra ML, Price-Feeney M, Prescott T, Goodenow C, Saewyc E, Rosario M. Girl2Girl: How to develop a salient pregnancy prevention program for cisgender sexual minority adolescent girls. J Adolesc 2020; 85:41-58. [PMID: 33038687 DOI: 10.1016/j.adolescence.2020.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 09/05/2020] [Accepted: 09/09/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Although sexual minority girls are more likely than heterosexual girls to be pregnant during adolescence, programs tailored to their needs are non-existent. Here we describe the iterative development of Girl2Girl, a text messaging-based pregnancy prevention program for cisgender lesbian, gay, bisexual and other sexual minority (LGB+) girls across the United States. METHODS Four activities are described: 1) 8 online focus groups to gain feedback about intended program components (n = 160), 2) writing the intervention content, 3) 4 online Content Advisory Teams that reviewed and provided feedback on the salience of drafted intervention content (n = 82), and 4) a beta test to confirm program functionality, the feasibility of assessments, and the enrollment protocol (n = 27). Participants were 14-18-year-old cisgender LGB+ girls recruited nationally on social media. Across study activities, between 52% and 70% of participants were 14-16 years of age, 10-22% were Hispanic ethnicity, and 30-44% were minority race. RESULTS Focus group participants were positive about receiving text messages about sexual health, although privacy was of concern. Thus, better safeguards were built into the enrollment process. Teens in the Content Advisory Teams found the content to be approachable and compelling, although many wanted more gender-inclusive messaging. Messages were updated to not assume people with penises were boys. Between 71 and 86% of participants in the beta test provided weekly feedback, most of which was positive; no one withdrew during the seven-week study period. CONCLUSIONS This careful step-by-step iterative approach appears to have resulted in a high level of intervention feasibility and acceptability.
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Affiliation(s)
- Michele L Ybarra
- Center for Innovative Public Health Research, 555 N El Camino Real, San Clemente, CA, 92672, USA.
| | - Myeshia Price-Feeney
- Center for Innovative Public Health Research, 555 N El Camino Real, San Clemente, CA, 92672, USA; The Trevor Project, PO Box 69232, West Hollywood, CA, 90069, USA
| | - Tonya Prescott
- Center for Innovative Public Health Research, 555 N El Camino Real, San Clemente, CA, 92672, USA
| | | | - Elizabeth Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, Vancouver Campus, T222-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Margaret Rosario
- Department of Psychology, The City University of New York, 160 Convent Avenue New York, NY, 10031, USA
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Rosario M, Goodenow C, Ybarra M, Saewyc E, Prescott T. Reasons Lesbian and Bisexual Adolescent Girls Have or Might Have Sex with Females or Males: Implications for Discordance between Sexual Identity and Behaviors and for Prevention of Pregnancy and STIs. JOURNAL OF SEX RESEARCH 2020; 57:966-978. [PMID: 32425068 DOI: 10.1080/00224499.2020.1753638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We examined reasons lesbian and bisexual adolescent girls have sex or, if sexually inexperienced, might have sex with girls or boys, and the role of internalized homonegativity in these relations and among lesbians. Girls were recruited online and classified as lesbian (n = 129) or bisexual (n = 193); the classification was validated. Love and pleasure were common reasons for having sex with girls, although more lesbian girls (LG) than bisexual girls (BG) endorsed love. BG, relative to LG, had sex with girls because they were curious or wanted to verify their sexual identity. Love and pleasure were motives for having sex with boys for BG. They were common reasons for potentially having sex with either sex among sexually inexperienced girls, but both were more likely for BG than LG for sex with boys. Internalized homonegativity did not mediate the relation between sexual identity and reasons for sex, but LG just with male partners were more homonegative than LG just with female partners. The findings indicate that LG and BG should not be combined into a single group, provide insights into the discordance between sexual identity and behaviors, and have implications for reducing risk for pregnancy and sexually transmitted infections among sexual minority girls.
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Affiliation(s)
- Margaret Rosario
- Department of Psychology, The City University of New York-City College and Graduate Center
| | | | | | - Elizabeth Saewyc
- Stigma and Resilience among Vulnerable Youth Centre, School of Nursing, University of British Columbia
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15
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Paschen-Wolff MM, Greene MZ, Hughes TL. Sexual Minority Women's Sexual and Reproductive Health Literacy: A Qualitative Descriptive Study. HEALTH EDUCATION & BEHAVIOR 2020; 47:728-739. [PMID: 32506954 PMCID: PMC7568910 DOI: 10.1177/1090198120925747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although sexual minority women (SMW) are at risk for cervical cancer and sexually transmitted infections (STIs), they may not seek preventative sexual and reproductive health care at the same rates as their heterosexual peers. We conducted a qualitative descriptive study of 22 adult SMW, a subsample of participants enrolled in the Chicago Health and Life Experiences of Women study. The aim was to describe the sexual and reproductive health literacy of this community sample based on qualitative themes, using an integrated model of health literacy. This model considers not only access to information but also understanding, appraisal, and application of information. We found that family of origin, health care providers, and school-based sexual education were the most important sources of sexual and reproductive health information. Participants described their understanding, appraisal, and application of sexual and reproductive health information as interdependent concepts. Pap test literacy and decision making were strongly independent, with SMW seeking various sources of information, or were driven by health care providers, with SMW following instructions and trusting provider advice. STI-related literacy hinged on whether the participant perceived SMW as at risk for STIs. Our findings reinforce that simply having access to information is insufficient to enact health behaviors that reflect full literacy. Findings have implications for health care providers, who should provide evidence-based recommendations for their SMW clients, and for public health practitioners and educators, who could make sexual health education more inclusive of and specific to the needs of SMW.
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Affiliation(s)
- Margaret M. Paschen-Wolff
- Columbia University Irving Medical Center at New York State Psychiatric Institute, New York, NY, USA
| | - Madelyne Z. Greene
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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16
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Everett BG, Turner B, Hughes TL, Veldhuis CB, Paschen-Wolff M, Phillips G. Sexual Orientation Disparities in Pregnancy Risk Behaviors and Pregnancy Among Sexually Active Teenage Girls: Updates from the Youth Risk Behavior Survey. LGBT Health 2020; 6:342-349. [PMID: 31618165 DOI: 10.1089/lgbt.2018.0206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose: The purpose of this study was to determine the extent to which sexual identity and/or sexual behaviors were associated with pregnancy risk factors (condom use, alcohol or other drug use before sex, and World Health Organization [WHO] Tier 1 [i.e., intrauterine device, implant] or Tier 2 [i.e., injectable, pill, patch, or ring] contraception use) and teen pregnancy among female high school students who reported having a sexual relationship with a male partner. Methods: Data were from the Youth Risk Behavior Survey (YRBS; 2005-2015) (n = 63,313). Logistic regression was used to analyze sexual identity and behavior disparities in pregnancy risk behaviors and teen pregnancy. Interactions between sexual identity and behavior were also tested. All models adjusted for the YRBS complex sampling frame. Results: Girls who reported being unsure of their sexual identity were less likely to use condoms or a WHO Tier 1 or Tier 2 contraceptive method at last sex, and more likely to report alcohol or other drug use at last sex than heterosexual girls. Girls who identified as lesbian were also less likely to use a condom at last sex, and girls who reported both male and female sexual partners were more likely to report alcohol or other drug use and less likely to use condoms at last sex. Girls who identified as bisexual were more likely to report pregnancy during teenage years than girls who identified as heterosexual. Conclusion: Our results support the need to assess both sexual identity and sexual behavior in research on teen pregnancy and pregnancy risk. Furthermore, the finding that girls who were unsure of their sexual identity showed heightened risk highlights the need for additional research that includes this group.
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Affiliation(s)
| | - Blair Turner
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Tonda L Hughes
- School of Nursing, Columbia University, New York, New York.,Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York
| | | | - Margaret Paschen-Wolff
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York
| | - Gregory Phillips
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
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17
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McKay EA, Fontenot HB. Parent-Adolescent Sex Communication with Sexual and Gender Minority Youth: An Integrated Review. J Pediatr Health Care 2020; 34:e37-e48. [PMID: 32861429 DOI: 10.1016/j.pedhc.2020.04.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/03/2020] [Accepted: 04/13/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Sexual and gender minority (SGM) youth experience adverse sexual health outcomes at higher rates than their heterosexual and cisgender peers. Although parent-adolescent sex communication (PASC) is associated with improved sexual health outcomes among heterosexual youth, less is known about PASC with SGM youth. METHODS Studies describing experiences of SGM youth and parents during PASC and/or health outcomes of PASC were reviewed. RESULTS Eleven studies met inclusion criteria, and six themes emerged. These included: (1) limited communication and barriers to communication, (2) impact of SGM disclosure on communication, (3) HIV and/or sexually transmitted disease-focused communication, (4) heteronormative communication, (5) outcomes of communication, and (6) youth preferences for PASC. DISCUSSION Parent-adolescent sex communication was complicated by barriers to communication and was limited, heteronormative, and influenced by SGM disclosure. Parent-adolescent sex communication may improve sexual health outcomes, but adequate parental education and guidance is lacking. This review identifies ways that health providers can foster positive and inclusive PASC.
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Abstract
Rates of sexual activity, pregnancies, and births among adolescents have continued to decline during the past decade to historic lows. Despite these positive trends, many adolescents remain at risk for unintended pregnancy and sexually transmitted infections (STIs). This technical report discusses the new data and trends in adolescent sexual behavior and barrier protection use. Since 2017, STI rates have increased and use of barrier methods, specifically external condom use, has declined among adolescents and young adults. Interventions that increase availability of or accessibility to barrier methods are most efficacious when combined with additional individual, small-group, or community-level activities that include messages about safer sex. Continued research informs public health interventions for adolescents that increase the consistent and correct use of barrier methods and promote dual protection of barrier methods for STI prevention together with other effective methods of contraception.
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Affiliation(s)
- Laura K Grubb
- Departments of Pediatrics and Public Health and Community Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts
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19
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Wikramanayake RM, Paschen-Wolff MM, Matebeni Z, Reddy V, Southey-Swartz I, Sandfort TGM. Southern African Lesbian and Bisexual Women Responses to Symptoms of Sexually Transmitted Infections. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1887-1902. [PMID: 31950379 PMCID: PMC7321908 DOI: 10.1007/s10508-019-01581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/11/2019] [Accepted: 10/31/2019] [Indexed: 06/10/2023]
Abstract
Sexually transmitted infection (STI) in lesbian and bisexual women is a relatively unexplored topic, particularly for women from low- and middle-income countries. Despite perceptions that women who have sex with women (WSW) are at negligible risk of contracting STI, existing research demonstrates that WSW do become infected with STI. Given the opposition between assumptions of invulnerability and the observed risks, we explored how WSW would respond to symptoms of STI (i.e., wait until symptoms passed, see a medical doctor, and inform sexual partners). We used data collected as part of a collaboration between academic researchers and community-based LGBTQ organizations in Botswana, Namibia, South Africa, and Zimbabwe. Chi-squared tests were used to test whether participants' responses to hypothetical STI symptoms varied in relation to several intrapersonal, interpersonal, and structural factors. Multivariable logistic regression (backward) was used to assess whether these variables were independently associated with women's responses. Most women would be proactive in response to potential STI symptoms and would see a medical doctor. However, most women would not inform their sexual partner of symptoms of STI. Findings demonstrate several intrapersonal, interpersonal, and structural factors that influence WSW's health agency, and show a clustering of high-risk factors among women who would not be proactive about their health. Our findings suggest the need for improved health and health care of WSW in Southern Africa.
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Affiliation(s)
- Radhika M Wikramanayake
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
| | - Margaret M Paschen-Wolff
- Department of Psychiatry, Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, USA
| | - Zethu Matebeni
- Department of Sociology, University of the Western Cape, Cape Town, South Africa
| | - Vasu Reddy
- Faculty of the Humanities, University of Pretoria, Pretoria, South Africa
| | | | - Theo G M Sandfort
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
- Department of Psychology, University of Pretoria, Pretoria, South Africa.
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20
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Solazzo AL, Agénor M, Austin SB, Chavarro JE, Charlton BM. Sexual Orientation Differences in Cervical Cancer Prevention among a Cohort of U.S. Women. Womens Health Issues 2020; 30:306-312. [PMID: 32249004 PMCID: PMC7347453 DOI: 10.1016/j.whi.2020.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 01/13/2020] [Accepted: 02/18/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although much has been published in recent years on differences in Papanicolaou (Pap) tests across sexual orientation, other aspects of cervical cancer prevention remain underexplored, such as human papillomavirus (HPV) vaccination, HPV co-tests, or abnormal Pap tests. METHODS Data came from participants (aged 24-54 years) enrolled in an ongoing, longitudinal, U.S.-based cohort study, the Nurses' Health Study 3 (N = 12,175). Analyses were restricted to participants who met the current guidelines for care (e.g., ≥21 years of age for Pap tests). RESULTS Mostly heterosexual women were more likely to initiate HPV vaccination than completely heterosexual women with no same-sex partners. All other comparisons across sexual orientation for HPV vaccination initiation and completion and the age of initiation were not statistically significant. Compared with completely heterosexual women with no same-sex partners, mostly heterosexual and lesbian women had lower odds of having a Pap test within the past 2 years. Completely heterosexual women with same-sex partners, mostly heterosexual women, and bisexual women had their first Pap test at an earlier age, had higher odds of having an HPV co-test, and had higher odds of having a positive HPV or abnormal Pap test compared with completely heterosexual women with no same-sex partners. In contrast, lesbian women had lower odds of having positive HPV or abnormal Pap results (odds ratio, 0.65; 95% confidence interval, 0.49-0.86) than completely heterosexual women with no same-sex partners. CONCLUSIONS There are significant differences across sexual orientation groups in cervical cancer prevention for Pap test timing and positive HPV and abnormal Pap tests, but few differences in HPV vaccination initiation, completion, and age at initiation. Interventions should focus on increasing routine Pap testing among mostly heterosexual and lesbian women.
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Affiliation(s)
- Alexa L Solazzo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Adolescent, Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.
| | - Madina Agénor
- Department of Community Health, Tufts University, Boston, Massachusetts; Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts; The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - S Bryn Austin
- Division of Adolescent, Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jorge E Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brittany M Charlton
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Adolescent, Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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21
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Paschen-Wolff MM, Reddy V, Matebeni Z, Southey-Swartz I, Sandfort T. HIV and sexually transmitted infection knowledge among women who have sex with women in four Southern African countries. CULTURE, HEALTH & SEXUALITY 2020; 22:705-721. [PMID: 31345116 PMCID: PMC6982583 DOI: 10.1080/13691058.2019.1629627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/05/2019] [Indexed: 06/10/2023]
Abstract
Women who have sex with women in Southern Africa, where HIV prevalence is high, are often presumed to have minimal risk for sexually transmitted infections (STI) and HIV despite research documenting female-to-female transmission. This study examined the demographic and social factors contributing to female-to-female STI/HIV transmission knowledge among Southern African women who have sex with women using an integrated model of health literacy. In collaboration with community-based organisations in Botswana, Namibia, South Africa and Zimbabwe, data were collected through anonymous surveys (N = 591). Multivariable stepwise forward logistic regression assessed independent associations between participant characteristics and high vs. low knowledge using five items. Overall, 64.4% (n = 362) of women had high knowledge; 35.6% (n = 200) had low knowledge. Higher education (adjusted odds ratio [aOR]: 2.24, 95% confidence interval [CI]: 1.48, 3.40), regular income (aOR: 2.14, 95% CI: 1.43, 3.21), residence in Botswana (aOR: 3.12, 95% CI: 1.15, 8.48) and having ever received tailored STI/HIV information (aOR: 2.17, 95% CI: 1.41, 3.32) predicted significantly higher odds of high knowledge in the final multivariable model. Results suggest opportunities for peer-led sexual health programming and expanded HIV prevention campaigns addressing women who have sex with women.
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Affiliation(s)
- Margaret M. Paschen-Wolff
- HIV Center for Clinical and Behavioral Studies at the NY State Psychiatric Institute and Columbia University, Department of Psychiatry, Division of Gender, Sexuality, and Health, New York, NY, USA
| | - Vasu Reddy
- Faculty of Humanities, University of Pretoria, Hatfield, South Africa
| | - Zethu Matebeni
- Department of Anthropology and Sociology, University of the Western Cape, Bellville, South Africa
| | | | - Theodorus Sandfort
- HIV Center for Clinical and Behavioral Studies at the NY State Psychiatric Institute and Columbia University, Department of Psychiatry, Division of Gender, Sexuality, and Health, New York, NY, USA
- Department of Psychology, University of Pretoria, Hatfield, South Africa
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22
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Obón-Azuara B, Gasch-Gallén Á, Gutiérrez-Cía I, Tomás-Aznar C. [Where are the women in HIV/AIDS prevention campaigns in Spain? The importance of the gender perspective and affective-sexual diversity]. Aten Primaria 2020; 52:214-217. [PMID: 32007319 PMCID: PMC7063131 DOI: 10.1016/j.aprim.2019.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/14/2019] [Accepted: 03/29/2019] [Indexed: 11/25/2022] Open
Affiliation(s)
- Blanca Obón-Azuara
- Servicio de Medicina Intensiva, Hospital Clínico Universitario de Zaragoza, Zaragoza, España; Grupo Interdisciplinar Independiente de Estudios de Género Aragón (GRIIEGA), Zaragoza, España.
| | - Ángel Gasch-Gallén
- Grupo Interdisciplinar Independiente de Estudios de Género Aragón (GRIIEGA), Zaragoza, España; Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
| | - Isabel Gutiérrez-Cía
- Grupo Interdisciplinar Independiente de Estudios de Género Aragón (GRIIEGA), Zaragoza, España; Dirección Médica, Hospital Clínico Universitario de Zaragoza, Zaragoza, España
| | - Concepción Tomás-Aznar
- Grupo Interdisciplinar Independiente de Estudios de Género Aragón (GRIIEGA), Zaragoza, España; Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
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23
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Bosse JD. Sexual and Gender Identity Development in Young Adults and Implications for Healthcare. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00215-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Sexual minority women are more likely to delay care, less likely to have a usual place of care, and more likely to exhibit higher risk behaviors such as smoking, obesity, heavy drinking resulting in a disproportionate number of chronic conditions. It is imperative for obstetrician-gynecologists to be at the forefront of providing comprehensive health care to all women, no matter their sexual orientation. This article seeks to discuss health care disparities as well as health behaviors and outcomes in this population. In addition, it will review the appropriate recommendations for clinical care of sexual minority women for the obstetrician/gynecologist.
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