Abstract B006: How should providers communicate around cervical cancer screening with LGBTQIA+ individuals with a cervix? “Be real, be caring…and actually listen to me”
Authors: Adsul Prajakta , Jacobson Kendal , Rodman Joe 
Published: January 2023

Abstract
Introduction: Sexual and gender minorities, referred to here as LGBTQIA+ individuals, experience several barriers to healthcare, including: discrimination from healthcare providers based on their sexual orientation, historical and systematic stigmatization from the healthcare community, and a lack of understanding around gender-based healthcare concerns from their providers. Such structural barriers have been understudied when considering cancer prevention interventions, such as vaccinations or screening. Most importantly, there is limited research on how best to promote the uptake of these interventions among the LGBTQIA+ community while addressing these barriers in healthcare. This study explored provider-related communications around cervical cancer screening for LGBTQIA+ individuals with a cervix. Methods: Using social media and outreach through community partners, we recruited 22 participants from New Mexico’s LGBTQIA+ community and conducted five discussions in two online formats (an itracks discussion board and a zoom video call) with the following groups: (1) lesbians; (2) bisexual and non-binary individuals; and (3) transgender and genderqueer individuals. Discussions focused on preventive health care and cervical cancer screening. Each discussion was audio recorded and transcribed. Study team members used a grounded theory approach to identify emergent themes. Results: Of the 22 participants, most were in the 31-40-year age group and nine (40%) participants identified as either Hispanic or African American. Almost 80% said they had a primary care provider, and all but two participants had screened for cervical cancer. In analyzing their experience around cervical cancer screening, three key themes emerged. First, many participants acknowledged that cervical cancer screening tests are effective and an important prevention tool for reducing their risk from cancer, often reasoned through cancer experiences of their family and friends. Second, several participants noted uninformed, insensitive, and awkward experiences around cervical health. Participants recounted providers who told them that they “didn’t need screening as I was only sleeping with other women” or “every time I go to a provider, I have to explain what queer is” or providers making “inappropriate comments about my sex life.” Finally, participants noted that although the screening procedure can be “physically unpleasant,” having providers that acknowledge the discomfort, actively empathize with patients, ensure they are “feeling safe and having a comfortable space”, and give patients some control during the screening procedure (i.e., allowing patient to insert the speculum themselves or using different sized speculums) could reduce the barriers towards improving cervical cancer screenings. Conclusion: Study analyses reveal the need for supplementing ongoing provider trainings around sexual and gender minority health with specific information around cervical health, to reduce the misinformation and anxiety experienced by many LGBTQIA+ members in the community.
Citation Format: Prajakta Adsul, Kendal Jacobson, Joe Rodman. How should providers communicate around cervical cancer screening with LGBTQIA+ individuals with a cervix? “Be real, be caring…and actually listen to me” [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B006.