Human Papillomavirus Risk Perceptions Among Young Adult Sexual Minority Cisgender Women and Nonbinary Individuals Assigned Female at Birth

Madina Agénor, Tufts University Jaquelyn L. Jahn, Harvard T.H. Chan School of Public Health Eriko Kay, Harvard T.H. Chan School of Public Health Rachel A. Bishop, Harvard T.H. Chan School of Public Health Sarah M. Peitzmeier, University of Michigan School of Nursing Jennifer Potter, Harvard Medical School S. Bryn Austin, Harvard T.H. Chan School of Public Health

First published online:

| DOI: https://doi.org/10.1363/psrh.12087
Abstract / Summary

Some sexual minority women may be less likely than other women to engage in human papillomavirus (HPV) prevention behaviors. Although risk perceptions have been found to be associated with health behaviors, HPV risk perceptions among U.S. sexual minority women have not been examined.


In 2016–2017, in‐depth interviews were conducted in Boston with 29 sexual minority individuals aged 18–36 who were assigned female at birth (AFAB) and identified as women or nonbinary. Purposive sampling was used to recruit participants online, through community‐based and student organizations, and by word of mouth. Thematic analysis was employed to examine participants’ HPV risk perceptions.


Participants incorrectly linked HPV risk to the exchange of genital fluids, and a hierarchy of perceived risk emerged in relation to sexual orientation: Individuals who engage in penile‐vaginal sex with partners who were assigned male at birth (AMAB) were perceived to be at highest risk, and lesbians and individuals with only AFAB partners were perceived to be at low risk. Lesbians and participants with only AFAB partners identified sex with bisexual women or AFAB individuals with AMAB partners as a risk factor for HPV infection. Risk perceptions were shaped by health care providers’ linking HPV risk to sex with AMAB individuals, a lack of discussion of HPV with parents and peers, and the exclusion of information on HPV and sexual minority women from school‐based sex education.


Interventions providing sexual minority AFAB individuals with comprehensive, accurate and tailored information about HPV risk are needed.

Author's Affiliations

Madina Agénor is Gerald R. Gill Assistant Professor of Race, Culture and Society, Department of Community Health, Tufts University, Medford, MA. Jaquelyn L. Jahn is a Ph.D. candidate, Eriko Kay is research coordinator, Rachel A. Bishop is research assistant and S. Bryn Austin is professor—all in the Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston. Sarah M. Peitzmeier is research fellow, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor. Jennifer Potter is professor, Department of Medicine, Harvard Medical School, Boston.


The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.