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Evaluating Sexual Orientation and Gender Identity Differences in Human Papillomavirus and Related Cancer Preventive Interventions

Corey, Stephanie (2019) Evaluating Sexual Orientation and Gender Identity Differences in Human Papillomavirus and Related Cancer Preventive Interventions. Master Essay, University of Pittsburgh.

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Background: Sexual and gender minorities (SGM) are at unique risk for contracting Human Papillomavirus (HPV) and developing related cancers (cervical, anal, head/neck, vulvar, penile) compared to their heterosexual cisgender peers. This risk is attributed to riskier sexual practices, lack of SGM-specific cancer education, and delay in routine cancer screenings. Incidence of HPV and late-stage cancer diagnoses can be reduced with HPV vaccines and routine screening. Minimal research has assessed if there are disparities in preventive interventions between SGM and non-SGM individuals. Therefore, this study examined gender and sexuality differences in HPV preventive interventions to inform the understudied field of SGM cancer prevention.
Methods: From 2015-2016, the Allegheny County Health Department (Pittsburgh, PA) commissioned a health survey of 9,026 adults aged 18-99 years using probability-based sampling. We examined differences by gender identity (cisgender women versus cisgender men and transgender) and sexual identity (heterosexual versus gay/lesbian, bisexual, and other) for lifetime receipt of HPV vaccine and number of HPV vaccines. Among cisgender women, we also examined sexuality differences in HPV and Pap tests. Weighted logistic and multinomial logistic regression analyses were adjusted for age, race/ethnicity, education, marital status, and income.
Results: Compared with cisgender women, transgender individuals had higher odds (AOR: 13.97; 95% CI: 1.13, 172.53) of never receiving an HPV vaccine. Compared with heterosexual cisgender women: lesbians had higher odds (AOR 3.99; 95% CI: 1.02, 15.63) of never receiving the HPV vaccine; bisexual women had higher odds (AOR: 2.90; 95% CI: 1.09, 7.71) of not receiving an HPV test within the recommended screening guidelines; and cisgender women who reported their sexuality as ‘other’ had higher odds (AOR: 7.33; 95% CI: 1.24, 43.30) of never receiving an HPV test and (AOR: 10.74; 95% CI: 2.39, 48.21) never receiving a Pap Test.
Conclusion: Transgender people as well as sexual minority cisgender women are less likely to engage in some cancer preventive interventions. These findings highlight existing health disparities between SGM and their heterosexual cisgender counterparts in Allegheny County and solidify the public health significance of creating SGM-specific interventions. Future interventions should assess SGM’s current barriers to HPV and related cancer care, evaluate health care provider’s knowledge and practices involving SGM patients, and increase education efforts to specifically target SGM.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairHaggerty, Catherine haggertyc@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberCoulter, Robert
Committee MemberBear, Toddtobst2@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberJones, Lyndalynda.jones@alleghenycounty.usUNSPECIFIEDUNSPECIFIED
Date: 24 April 2019
Date Type: Completion
Number of Pages: 36
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 04 Oct 2019 21:00
Last Modified: 01 May 2022 05:15


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