Breast health behavior among lesbians: the role of health beliefs, heterosexism, and homophobia.

The Health Belief Model was used as a conceptual framework for exploring how health beliefs and perceptions of heterosexism and homophobia in health care related to lesbians' breast health behaviors, including use of breast exams and mammograms, visits to health care providers, and use of complementary/alternative care. A total of 173 exclusively homosexual women completed survey measures assessing health beliefs, experiences of heterosexism/homophobia, and health maintenance behaviors as these related to breast health. Findings indicated that women perceived heterosexism and homophobia from providers to influence the amount of discussion they had with providers and, to a lesser extent, care received, frequency of service use, and health outcomes. Perceptions of heterosexism and homophobia in health care settings significantly contributed, beyond routine health beliefs, to women's use of breast self-exams, visitation to health care providers, and use of complementary/alternative care. Implications for culturally competent care are discussed.