Abstract
Background
Research on the sexual and reproductive health of sexual minority women, especially
those of color, is limited.
Methods
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).
Results
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.
Conclusions
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.
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Biography
Madina Agénor, ScD, MPH, is an Assistant Professor in the Department of Social and Behavioral Sciences at Harvard T.H. Chan School of Public Health. Her research pertains to social inequalities in sexual and reproductive health in relation to gender, sexual orientation, and race/ethnicity, especially among marginalized women and girls.
Biography
S. Bryn Austin, ScD, is Professor of Pediatrics at Harvard Medical School and Professor of Social and Behavioral Sciences at Harvard T.H. Chan School of Public Health. Her research pertains to sexual and gender minority health and the prevention of eating disorders.
Biography
Daniel Kort, BA, is a doctoral student in the Department of Psychology at the University of Washington. His research pertains to the effects of discrimination on health outcomes among marginalized social groups.
Biography
Erika L. Austin, PhD, MPH, is an Assistant Professor in the Department of Biostatistics at the University of Alabama at Birmingham School of Public Health. Her research pertains to the health of disadvantaged populations, including sexual minority women and homeless veterans.
Biography
Christina A. Muzny, MD, is an Assistant Professor in the Division of Infectious Diseases at the University of Alabama at Birmingham School of Medicine. Her clinical and research interests focus on sexually transmitted infections among underserved groups of women, including lesbians and bisexual women.
Article info
Publication history
Published online: August 18, 2016
Accepted:
July 11,
2016
Received in revised form:
July 1,
2016
Received:
November 12,
2015
Footnotes
Funding statement: This research was supported by a Developmental Award by the American Sexually Transmitted Diseases Association granted to CA Muzny. At the time of the study, CA Muzny was supported by grant K23AI106957-01A1 from the National Institute of Allergy and Infectious Diseases, M Agénor was supported by National Cancer Institute grant R25CA057711-20, and SB Austin was supported by U.S. Maternal and Child Health Bureau training grants T71-MC00009 and T76-MC00001.
Financial disclosure: The authors have no financial conflicts to disclose.
Identification
Copyright
© 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc.
