CERVICAL-CANCER RISK AND PAPANICOLAOU SCREENING IN A SAMPLE OF LESBIAN AND BISEXUAL WOMEN

BACKGROUND. Previous studies of lesbian and bisexual women have sugges ted 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. METHODS. This s tudy combined focus group data (N=44) with a self-administered questio nnaire (N=576) to explore the health concerns of lesbian women, includ ing the prevalence of risk factors for cervical cancer, the frequency of Papanicolaou (Pap) test screening, and the barriers to obtaining ca re. We examined the influence of women's perceptions regarding the kno wledge and sensitivity of their clinicians to lesbian issues and their experiences of discrimination in the medical setting an Pap test util ization. RESULTS. Respondents reported risk factors for cervical cance r, including multiple past or current sexual partners (both male and f emale), early age at first coitus, history of sexually transmitted dis eases, and cigarette smoking. One fourth of respondents had not had a Pap test within the last 3 years, including 39 (7.6%) who had never ha d a Pap test. Women who reported ti-at their health care providers wer e more knowledgeable and sensitive to lesbian issues were significantl y more likely to have had a Pap test within the last year, even when c ontrolling for age, education, income, and insurance status. CONCLUSIO NS. Lesbian women are at risk for cervical cancer and should receive r outine cytologic screening according to individual risk assessment. Th e quality of clinician-patient interactions strongly influences care-s eeking within the population sampled.