At the intersection of sexual orientation, race/ethnicity, and cervical cancer screening: Assessing Pap test use disparities by sex of sexual partners among black, Latina, and white US women
At the intersection of sexual orientation, race/ethnicity, and cervical cancer screening: Assessing Pap test use disparities by sex of sexual partners among black, Latina, and white US women
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DOI：
10.1016/j.socscimed.2014.06.039
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发表时间：
2014-09-01
影响因子：
5.4
通讯作者：
Gottlieb, Barbara R.
中科院分区：
文献类型：
--
作者：
Agenor, Madina;Krieger, Nancy;Gottlieb, Barbara R.
了解社会不平等的各个方面如何影响个人和人口的健康对公共卫生提出了关键挑战。在生态社会理论和交叉性的指导下，我们使用 2006-2010 年全国家庭成长调查（全国概率样本）的数据来调查性取向、性伴侣性别和种族/民族的某一维度如何共同影响 21-44 岁美国黑人、拉丁裔和白人女性 (N = 8840) 的巴氏试验使用情况。我们测试了性伴侣的性别与种族/民族之间的相互作用（p = 0.015），并估计了每个种族/民族的多变量逻辑回归模型，并根据社会人口统计因素进行了调整。在白人女性中，过去一年中只有女性性伴侣的女性使用巴氏试验的调整后赔率显着低于过去一年中只有男性性伴侣的女性（比值比 [OR] = 0.25，95% 置信区间 [CI]：0.12,0.52），黑人女性中可能更低（OR = 032,95% CI：0.07,1.52）；拉丁裔女性之间没有明显差异（OR = 1.54，95% CI：0.31,7.73）。此外，在白人（OR = 0.30，95% CI：0.22,0.41）和黑人（OR = 0.23，95% CI：0.15,037）女性中，过去一年没有性伴侣的女性使用巴氏试验的调整后几率显着低于过去一年只有男性性伴侣的女性，而拉丁裔女性中则略低（OR = 0.63，95% CI：0.22,0.41）。 0.38,1.03)。在模型中添加医疗保健指标完全解释了白人女性中只有女性性伴侣与只有男性性伴侣的女性以及拉丁裔女性中没有男性性伴侣与只有男性性伴侣的女性在巴氏试验使用方面的差异。生态社会理论和交叉性可以结合使用，从概念上和操作上阐明以前未分析的社会不平等多个维度的健康差异。 (C) 2014 Elsevier Ltd. 保留所有权利。
Understanding how various dimensions of social inequality shape the health of individuals and populations poses a key challenge for public health. Guided by ecosocial theory and intersectionality, we used data from the 2006-2010 National Survey of Family Growth, a national probability sample, to investigate how one dimension of sexual orientation, sex of sexual partners, and race/ethnicity jointly influence Pap test use among black, Latina and white U.S. women aged 21-44 years (N = 8840). We tested for an interaction between sex of sexual partners and race/ethnicity (p = 0.015) and estimated multivariable logistic regression models for each racial/ethnic group, adjusting for socio-demographic factors. The adjusted odds of Pap test use for women with only female sexual partners in the past year were significantly lower than for women with only male sexual partners in the past year among white women (odds ratio [OR] = 0.25, 95% confidence interval [CI]: 0.12,0.52) and may be lower among black women (OR = 032,95% CI: 0.07,1.52); no difference was apparent among Latina women (OR = 1.54, 95% CI: 0.31,7.73). Further, the adjusted odds of Pap test use for women with no sexual partners in the past year were significantly lower than for women with only male sexual partners in the past year among white (OR = 0.30, 95% CI: 0.22,0.41) and black (OR = 0.23, 95% CI: 0.15,037) women and marginally lower among Latina women (OR = 0.63, 95% CI: 0.38,1.03). Adding health care indicators to the models completely explained Pap test use disparities for women with only female vs. only male sexual partners among white women and for women with no vs. only male sexual partners among Latina women. Ecosocial theory and intersectionality can be used in tandem to conceptually and operationally elucidate previously unanalyzed health disparities by multiple dimensions of social inequality. (C) 2014 Elsevier Ltd. All rights reserved.