Comparing Receipt of Cervical Cancer Screening and Completion of Human Papillomavirus Vaccination Using a New Construct of Sexual Orientation: A Serial Cross-Sectional Study

Purpose: We assessed differences in receipt of cervical cancer screening and completion of the human papillomavirus (HPV) vaccine series between sexual minority and non sexual minority women by using two sub-constructs of sexual orientation-gender of sexual partners and anatomy of sexual partners. Methods: We employed a serial cross-sectional design by using medical record data from August 2012 through August 2016 from an urban health center to compare receipt of cervical cancer screening and completion of the HPV vaccine series. In Wave 1 of the study, gender of sexual partners was the construct used. In Wave 2 of the study, anatomy of sexual partners was the construct used. Multivariable logistic regression analyses were conducted to determine the odds of being up-to-date on cervical cancer screening and completion of the HPV vaccine series among sexual minority women compared with non sexual minority women, with n = 729 in Wave 1 and n = 740 in Wave 2 of the study. Results: Sexual minority women in Wave 2 were significantly less likely to be up-to-date on cervical cancer screening than non sexual minority women (odds ratio = 0.457, p = 0.012, 95% confidence interval 0.248-0.843). We did not find a statistically significant association between receipt of cervical cancer screening and sexual minority status in Wave 1. No significant association between sexual minority status and completion of the HPV vaccine series was found in either Wave. Conclusion: This study provides important information for clinicians and researchers regarding a disparity in cervical cancer screening practices among sexual minority women, utilizing a novel approach for identifying these women.