Cervical Cancer Screening and Human Papillomavirus Vaccination among Korean Sexual Minority Women by Sex of Their Sexual Partners

Abstract

Cervical cancer-preventive behaviors in Korean sexual minority women (SMW) are underexplored. We aimed to assess the differences in cervical cancer screening uptake and completion of human papillomavirus (HPV) vaccination among Korean SMW by sex of their sexual partners. This cross-sectional study used data from the 2017 Korean Sexual Minority Women’s Health Study; we included Korean lesbian and bisexual women aged ≥20 years. They were divided into three groups: SMW with more than one male sexual partner (male only/both), SMW with only female sexual partners (female-only), or no sexual partner (no partner). Among the 671 participants, 266 (39.6%), 294 (43.8%), and 111 (16.5%) belonged to the male-only/both, female-only, and no partner groups, respectively. Compared to the male-only/both group, the female-only group was significantly less likely to have undergone cervical cancer screening (Adjusted odds ratio (AOR) = 0.24, 95% confidence interval (CI) = 0.15–0.37) and to have completed HPV vaccinations (AOR = 0.58, 95% CI = 0.37–0.91). In conclusion, Korean SMW with only female sexual partners had lower cervical cancer screening and HPV vaccination completion rates than SMW who had male sexual partners. More extensive efforts are needed to improve cervical cancer-preventive behaviors among Korean SMW.

Human Papillomavirus Infection: Knowledge, Risk Perceptions and Behaviors among SMW and AFAB

“…Several studies have confirmed that lesbians and women with only AFAB partners tend to perceive themselves as less likely to acquire HPV than bisexual women and (AMAB) [4,[40][41][42]. Moreover, studies have shown that SMW who have sex with bisexual women and AFAB individuals who have AMAB partners have a notable HPV risk factor [43].…”

Gynecological and breast cancer risk factors and screenings in lesbian and bisexual women

“…Among all women, these psychological variables were positively associated with never obtaining a Pap test and concealment was also negatively associated with clinical breast exam adherence. Kim, Lee & Choi-Kwon (43) Cervical cancer screening and human papillomavirus vaccination among Korean sexual minority women by sex of their sexual partners Descriptive 671 women LBW with only female partners had lower rates of Pap testing and completion of HPV vaccine than women with male and female partners.…”

“…a short training session with a lesbian doctor, it was found that one in four women (58-66 years) who did not have a Pap test had a Pap test within 3 years. (1) Similarly, in the studies of Kim et al (43) it was found that LBW with only female partners had lower rates of Pap testing and completion of HPV vaccine than women with male and female partners.…”

Canadian Guideline on the Management of a Positive Human Papillomavirus Test and Guidance for Specific Populations

“…In one study, 28% of sexual minority patients perceived that cervical cancer screening was unnecessary [ 81 ]. Compared to sexual minority patients with male partners, those with only female partners are less likely to have cervical screening [ 82 ]. In a survey of young bisexual and lesbian women, 30% of respondents had not had a Pap smear in the preceding 3 years [ 83 ].…”

“…The increased risk of CIN3+ in the former study is likely attributable to underscreening. In addition, fewer sexual minority patients undergo HPV vaccination [ 82 , 88 , 89 ]. Reported rates of smoking are also higher in the LGBTQ2S+ community, which is a known risk factor for the progression of HPV-related infections to cervical cancer [ 90 ].…”