Women’s Health
The relationship between sexual orientation and race/ethnicity and preventive health care utilization among Illinois women 21-65: Is intersectionality at play? Caitlin Meyer Krause* Caitlin Meyer Krause Kristin Rankin Arden Handler William Barshop Madison Levecke Brenikki Floyd
Background: Generally, lesbian, gay, and bisexual (LGB) women are less likely to receive routine health care including the well-woman visit (WWV), which provides an opportunity to receive cervical cancer screening (CCS). This study assessed the relationship between sexual orientation and receipt of preventive health services, including modification by race/ethnicity, among Illinois women aged 21-65.
Methods: The study used 2016, 2018, and 2020 Illinois Behavioral Risk Factor Surveillance System data among women aged 21-65 to examine rates of CCS within 3-5 years per US Preventive Services Taskforce guidelines (n=2848) and 2016-2018 and 2020-2021 data to examine WWV use (n=5863) by sexual orientation (heterosexual vs. LGB; not asked in 2019). Self-reported race/ethnicity was tested as an effect modifier to assess intersectionality. Using Poisson regression models, adjusted prevalence ratios (aPR) and 95% CIs were estimated with specialized techniques for the survey design and weighting. Covariates included age, education, marital status, employment, health insurance coverage, and race/ethnicity by sexual orientation.
Results: Overall, 4.6% of Illinois women aged 21-65 self-identified as LGB. Heterosexual and LGB women had a similar prevalence of receipt of both a WWV (77.1% and 71.7%, respectively; aPR=1.04, 95% CI: 0.95, 1.15) and CCS (85.3% and 83.4%, respectively; aPR=1.03, 95% CI: 0.93, 1.13). When stratified by race, Non-Hispanic (NH) Black heterosexual women had a higher prevalence of both services compared to LGB women; however, adjusted associations included the null. NH White and Hispanic women had similar prevalence of both visit types by sexual orientation.
Conclusion: In Illinois overall, heterosexual and LGB women receive preventive care screenings at similar rates. However, WWV and CCS receipt may differ between NH Black heterosexual and LGB women which may indicate missed opportunities for some women to receive preventive care.