Sexual orientation inequalities during provider-patient interactions in provider encouragement of sexual and reproductive health care.
Sexual orientation inequalities during provider-patient interactions in provider encouragement of sexual and reproductive health care.
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提供者与患者互动期间的性取向不平等，以鼓励提供者提供性健康和生殖健康护理。
DOI：
10.1016/j.ypmed.2019.105787
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发表时间：
2019
影响因子：
5.1
通讯作者：
Charlton,BrittanyM
中科院分区：
文献类型：
--
作者：
Solazzo,AlexaL;Tabaac,AriR;Agénor,Madina;Austin,SBryn;Charlton,BrittanyM
人乳头瘤病毒（HPV）疫苗接种，性传播感染（STI）测试和巴氏（Pap）测试率因性取向而异，这可能部分是由于医疗保健提供者（HCP）不均匀地推荐这种护理。数据（N= 17，675）来自今日成长研究（GUTS）（N=8039）和护士健康研究3（NHS 3）（N=9636）。在符合临床指南接受相关护理的参与者中，我们估计了HCP鼓励参与者进行HPV疫苗接种、STI检测或Pap检测的概率。无论性取向如何，与那些HCP不知道参与者性取向的参与者相比，HCP知道他们性取向的参与者更有可能被鼓励接受护理。性少数男性和女性更有可能被鼓励接受HPV疫苗接种，STI测试和巴氏试验，而不是同性恋，没有同性伴侣的完全异性恋者，性别和护理方面存在一些差异。女同性恋妇女是唯一的性取向亚组，不太可能被鼓励接受护理（HPV疫苗接种和巴氏试验）比他们的同性，完全异性恋的同行，没有同性伴侣（比值比[95%置信区间]：0.90 [0.80-1.00]和0.94 [0.91-0.98]，分别）。不同性取向的HCP鼓励护理的差异表明了不同性取向的利用差异的可能解释。在美国，HCP不鼓励所有性取向群体接种HPV疫苗，STI测试和Pap测试。女同性恋患者似乎是在鼓励下的巴氏试验的高风险。
The human papillomavirus (HPV) vaccination, sexually transmitted infection (STI) tests, and Papanicolaou (Pap) testing rates vary by sexual orientation, which may be due in part to healthcare providers (HCP) recommending this care unevenly. Data (N= 17,675) came from the Growing Up Today Study (GUTS) (N=8039) and Nurses' Health Study 3 (NHS3) (N=9636). Among participants who met clinical guidelines to receive the care in question, we estimated the probability of an HCP encouraging participants to have the HPV vaccination, STI tests, or Pap test. Regardless of sexual orientation, participants whose HCP knew their sexual orientation were more likely to have been encouraged to get care compared to those whose HCP did not know the participant's sexual orientation. Sexual minority men and women were more likely to be encouraged to obtain HPV vaccination, STI tests, and Pap test than same-gender, completely heterosexuals with no same-sex partners, with some variation by gender and the care in question. Lesbian women were the sole sexual orientation subgroup that was less likely to be encouraged to receive care (HPV vaccination and Pap test) than their same gender, completely heterosexual counterparts with no same-sex partners (odds ratio [95% confidence interval]: 0.90 [0.80–1.00] and 0.94 [0.91–0.98], respectively). The differences across sexual orientation in HCPs' encouragement of care indicate a possible explanation for differences in utilization across sexual orientation. Across the US, HCPs under-encourage HPV vaccination, STI tests, and Pap test for all sexual orientation groups. Lesbian patients appear to be at high risk of under-encouragement for the Pap test.