The interaction of sexual orientation and provider-patient communication on sexual and reproductive health in a sample of US women of diverse sexual orientations

Objective: Our goal was to examine associations among provider-patient communication, past-year contraceptive use and lifetime sexually transmitted infection. Methods: Data were analyzed cross-sectionally from 22,554 women in the Growing Up Today Study and Nurses' Health Study 3 between the follow-up period of 1996-2020. We used multivariable Poisson regression models adjusted for race/ethnicity, age in years, study cohort, and region of residence to obtain risk ratio (RR) associations and 95% confidence intervals (CI). Results: Provider-patient communication was associated with higher likelihood of using all methods of past-year contraceptive use (RRs ranging from 1.11 to 1.63) and lifetime STI diagnosis (RRs ranging from 1.18 to 1.96). Completely heterosexual women with no same-sex partners (referent) were 13% more likely than lesbians and 4% less likely than other groups to report a provider ever discussed their SRH. Significant interactions emerged between sexual minority status and provider-patient communication. Sexual minority women whose providers discussed their SRH were less likely to report contraceptive non-use in the past year (p < .0001). Conclusion: Provider-patient communication may benefit sexual minority women's contraceptive practices and engagement with STI testing. Practice implications: Differences in provider-patient SRH discussion by sexual orientation indicate lesbian women are not receiving the same attention in clinical encounters. 0 2021 Elsevier B.V. All rights reserved.

Automated summary

This study examined the associations among provider-patient communication, past-year contraceptive use, and lifetime sexually transmitted infection. The results showed that there was a correlation between provider-patient communication and both the use of contraceptive methods in the past year and the diagnosis of sexually transmitted infections. Sexual minority women who had discussions about their sexual and reproductive health with their providers were less likely to report non-use of contraceptives in the past year.