Receipt of preventive health care services by lesbians

Background: We measured receipt of age-appropriate preventive health servic es by lesbians and assessed whether provider and individual characteristics , including disclosure of sexual orientation, are independently associated with receipt of these services. Methods: A questionnaire was printed in a national biweekly gay, lesbian, a nd bisexual news magazine, and self-identified lesbians living in all U.S. states (N=6935) responded to the survey. Main outcome variables were receip t of a Pap smear within the preceding 1 and 2 years and, for women aged gre ater than or equal to 50, receipt of a mammogram within the past 1 and 2 ye ars. Results: Fifty-four percent had Pap smears within 1 year and 71% within 2 y ears, with increasing rates among older and more educated respondents. Seve nty percent of respondents aged greater than or equal to 50 had a mammogram in the past year, and 83% within 2 years; rates did not vary significantly controlling for education. Sixty percent had disclosed their sexual orient ation to their regular health care provider. Controlling for patient and pr ovider characteristics, disclosure was independently associated with receip t of Pap smears, but not mammograms. Conclusions: It is important for providers to identify their lesbian patien ts' unmet needs for preventive health care. Additionally, it is important f or providers to provide complete and appropriate preventive health care for their lesbian patients. Further research is needed to determine why lesbia ns are not receiving Pap smears at the recommended rate and whether this di sparity is reflective of aspects of cervical cancer screening or indicates a more general problem with access to health care including receipt of prev entive services.