Madina Agénor, Zinzi Bailey, Nancy Krieger, S. Bryn Austin, Barbara R. Gottlieb

Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, we conducted focus group discussions in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, we enrolled eighteen black LBQ women who participated in one of four focus groups. Using thematic analysis, we identified patient-provider communication-which consisted of four sub-themes: health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and socio-demographic background-as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women's health care, and increasing the presence of LBQ women of color in health care settings.