Abstract
Background
Health care providers are an important source of sexually transmitted infection (STI)
prevention information for young adult sexual minority women (SMW). However, very
few studies have described patient–provider STI communication in this understudied
and underserved population. We explore sexual minority women's experiences communicating
with health care providers about sexual health, with particular attention to STI prevention,
to inform programs and practices that address their unique needs and concerns.
Methods
We conducted 29 in-depth interviews with sexual minority cisgender women and nonbinary
assigned female at birth (AFAB) individuals aged 18–36 years. The sample included
White (55%), Asian (31%), Black (17.2%), and Latina (3.4%) participants. We used thematic
analysis with deductive and inductive coding to identify themes related to patient–provider
STI prevention communication.
Results
Heteronormative health care provider assumptions inhibited participants' willingness
to disclose their sexual orientation and discuss sexual health issues with providers.
Most sexual health conversations focused on pregnancy and contraception, which many
felt was irrelevant to them, and limited STI prevention recommendations to condom
use. Participants reported that some providers lacked medical knowledge on AFAB-to-AFAB
STI transmission and were not able to provide relevant STI prevention information.
Providers' bias related to gender identity and race/ethnicity furthered some participants'
mistrust generated from providers’ heteronormative assumptions.
Conclusions
Our study describes several barriers that AFAB sexual minorities felt inhibited their
patient–provider sexual health communication. Interventions are needed to improve
patient–provider STI prevention conversations with AFAB sexual minorities so they
can access the sexual health information they need to effectively protect themselves
from STIs.
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Biography
Jaquelyn L. Jahn, MPH, is a doctoral candidate at the Harvard T.H. Chan School of Public Health in the Department of Social and Behavioral Sciences. Her social epidemiologic research focuses on health inequities across gender, sexual orientation, and race/ethnicity.
Biography
Rachel A. Bishop, MPH, works to address systemic health inequities as Manager of External Affairs at MassHealth in the Office of Medicaid for the Commonwealth of Massachusetts.
Biography
Andy S.L. Tan, PhD, MPH, MBA, is Assistant Professor, Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health. His research is aimed at understanding health communication processes that contribute the burden of cancer and disparities across the cancer control continuum.
Biography
Madina Agénor, ScD, MPH, is Gerald R. Gill Assistant Professor of Race, Culture, and Society, Tufts University. She investigates health/health care inequities in relations to various dimensions of social inequality, especially sexual orientation, gender identity, and race/ethnicity, using an intersectional lens.
Article info
Publication history
Published online: February 25, 2019
Accepted:
January 10,
2019
Received in revised form:
January 8,
2019
Received:
September 6,
2018
Footnotes
Supported by American Cancer Society Postdoctoral Fellowship 128863-PF-15-149-01-CPHPS, project title: Sexual orientation and human papillomavirus vaccination among young women.
Identification
Copyright
© 2019 Jacobs Institute of Women's Health. Published by Elsevier Inc.
