title: Exploring the Cervical Cancer Screening Experiences of Black Lesbian, Bisexual, and Queer Women: The Role of Patient-Provider Communication.
abstract: Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, focus group discussions were conducted in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, the authors enrolled 18 black LBQ women who participated in one of four focus groups. Using thematic analysis, patient-provider communication was identified, which consisted of four sub-themes--health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and sociodemographic background--as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women's health care, and increasing the presence of LBQ women of color in health care settings.
authors.affiliation: a Department of Social and Behavioral Sciences , Harvard T. H. Chan School of Public Health , Boston , Massachusetts , USA.
authors.forename: Madina
authors.initials: M
authors.lastname: Agénor
authors.forename: Zinzi
authors.initials: Z
authors.lastname: Bailey
authors.forename: Nancy
authors.initials: N
authors.lastname: Krieger
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
authors.forename: Barbara R
authors.initials: BR
authors.lastname: Gottlieb
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001727:Bisexuality / Q000523:psychology*; D044383:Black People / Q000523:psychology*; D003144:Communication Barriers; D004192:Discrimination, Psychological; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D019538:Health Care Surveys; D054625:Healthcare Disparities; D018452:Homosexuality, Female / Q000523:psychology*; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration; D008404:Massachusetts; D008875:Middle Aged; D065006:Papanicolaou Test; D010817:Physician-Patient Relations; D036301:Qualitative Research; D063505:Racism; D012725:Sexual Behavior / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D001741:Black or African American
keywords: bisexual; cervical cancer screening; discrimination; lesbian; race; racism; sexual orientation