title: Influence of hormonal contraceptive use and health beliefs on sexual orientation disparities in Papanicolaou test use.
abstract: OBJECTIVE
  Reproductive health screenings are a necessary part of quality health care. However, sexual minorities underutilize Papanicolaou (Pap) tests more than heterosexuals do, and the reasons are not known. Our objective was to examine if less hormonal contraceptive use or less positive health beliefs about Pap tests explain sexual orientation disparities in Pap test intention and utilization.
  
  
  METHODS
  We used multivariable regression with prospective data gathered from 3821 females aged 18 to 25 years in the Growing Up Today Study (GUTS).
  
  
  RESULTS
  Among lesbians, less hormonal contraceptive use explained 8.6% of the disparities in Pap test intention and 36.1% of the disparities in Pap test utilization. Less positive health beliefs associated with Pap testing explained 19.1% of the disparities in Pap test intention. Together, less hormonal contraceptive use and less positive health beliefs explained 29.3% of the disparities in Pap test intention and 42.2% of the disparities in Pap test utilization.
  
  
  CONCLUSIONS
  Hormonal contraceptive use and health beliefs, to a lesser extent, help to explain sexual orientation disparities in intention and receipt of a Pap test, especially among lesbians.
authors.affiliation: Brittany M. Charlton is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Heather L. Corliss and S. Bryn Austin are with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA. Stacey A. Missmer, is with Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. A. Lindsay Frazier is with the Dana-Farber Cancer Institute, Boston, MA. Margaret Rosario is with the City University of New York, City College and Graduate Center, New York, NY. Jessica A. Kahn is with the Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Brittany M
authors.initials: BM
authors.lastname: Charlton
authors.forename: Heather L
authors.initials: HL
authors.lastname: Corliss
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
authors.forename: A Lindsay
authors.initials: AL
authors.lastname: Frazier
authors.forename: Margaret
authors.initials: M
authors.lastname: Rosario
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Kahn
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
mesh_terms: D000293:Adolescent; D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D055088:Early Detection of Cancer; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D019529:Sexuality / Q000523:psychology* / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal