Jaquelyn L Jahn1, Rachel A Bishop2, Andy S L Tan3, Madina Agénor4. 1. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Electronic address: jaquelyn_jahn@g.harvard.edu. 2. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; MassHealth, Office of Medicaid, Executive Office of Health & Human Services, Commonwealth of Massachusetts, Boston, Massachusetts. 3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts. 4. Department of Community Health, Tufts University, Medford, Massachusetts.
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.
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.
Authors: Allison M Baker; Jaquelyn L Jahn; Andy S L Tan; Sabra L Katz-Wise; Kasisomayajula Viswanath; Rachel A Bishop; Madina Agénor Journal: Sex Res Social Policy Date: 2020-09-11
Authors: Ariella R Tabaac; Megan E Sutter; Sebastien Haneuse; Madina Agénor; S Bryn Austin; Carly E Guss; Brittany M Charlton Journal: Patient Educ Couns Date: 2021-05-16
Authors: Cornelis A Rietmeijer; Patricia J Kissinger; Vincent Guilamo-Ramos; Charlotte A Gaydos; Edward W Hook; Aimee Mead; Sophie Yang; Amy Geller; Sten H Vermund Journal: Sex Transm Dis Date: 2022-02-01 Impact factor: 3.868