A web-based survey was conducted with a variety of online groups to enhance our understanding of cervical cancer screening behavior among women with various sexual orientations, as well as to assess the feasibility of collecting data from women of various sexual orientations via the Internet. While several mailing lists and a forum were used in the sampling, the largest proportion of women came from an online journaling site that has a strong sense of community and where the members are accustomed to participating in online projects.
A total of 1750 surveys were collected, but the sample was limited to the 1374 women with complete surveys that were from the United States. According to an algorithm that included self-identified sexual orientation, recent and lifetime sexual history and relationship status, the sample included 694 (50.5%) heterosexuals, 499 (36.3%) bisexuals and 181 (13.2%) lesbians. Heterosexual and bisexual women were more likely to be in maintenance than any other stage, while lesbians were more likely to be in any stage other than maintenance than heterosexual and bisexual women were. History of birth control pills, knowing of a health care provider to go to for cervical cancer screening, having positive perceptions about cervical cancer screening, having a history of abnormal pap tests or sexually transmitted diseases, being diligent about health care and believing that a cervical cancer diagnosis is not a matter of chance are positively associated with women being screened, regardless of sexual orientation. Having pro-cervical cancer screening subjective norms and perceiving a cervical cancer diagnosis as being serious are also associated with stage of change, but vary differently based upon sexual orientation. While sexual orientation is significantly related to stage of change for cervical cancer screening, several factors or groups of factors diminish or alter this association. The factor with the largest influence on this association is past or current birth control pill use.