Background: Lesbian women are 25% less likely to receive cervical cancer screening than other women which contributes to lesbian women’s higher risk for cervical cancer. The purposes of this study were to measure primary care providers' (PCPs) bias toward lesbian women and to assess the association of PCPs’ implicit and explicit bias toward lesbian women with PCPs’ recommendations for cervical cancer screening in this population. Methods: In this cross-sectional study, 182 PCPs in Kentucky completed a web-based survey that included a clinical vignette, an Implicit Association Test (IAT), and explicit bias measures. PCP’s bias was analyzed descriptively. Two-sample t-tests compared bias scores between PCPs who recommended and did not recommend cervical cancer screening for a lesbian woman. Multiple linear regression determined demographic predictors of implicit and explicit bias. Results: The PCP participants average IAT score (possible score range -2.00 to +2.00) was 0.34 with positive scores indicating preferences for heterosexual women and negative scores indicating preferences for lesbian women. There was no association between IAT scores and PCPs’ cervical cancer screening recommendations for lesbian women (p = .15). PCPs who supported same sex marriage (p < .001) and same-sex partners’ adoption of children (p < .02) and those who were less religious (p < 0.1) had significantly lower IAT scores. Characteristics such as type of PCP, age, and years in practice were not significantly associated with PCPs’ implicit and explicit bias. Conclusions: PCPs’ implicit and explicit bias was not associated with their cervical cancer screening recommendations for lesbian women in this study; however, the PCPs’ had implicit bias toward lesbian women. While not uncommon, this finding supports the need for identification of implicit bias and for implicit bias training to mitigate of PCPs’ bias toward lesbian women to prevent the potential negative effects of PCPs’ implicit bias on cervical cancer screening and other health outcomes for lesbian women.
Citation Format: Mollie E. Aleshire, Amanda Fallin-Bennett, Mary Kay Rayens, Keisa Fallin-Bennett, Jennifer Hatcher. Does primary care providers' implicit and explicit bias impact cervical cancer screening recommendations for lesbian women? [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-267.