Maternal Factors and Sexual Orientation-Related Disparities in Cervical Cancer Prevention

Womens Health Issues. 2019 May-Jun;29(3):238-244. doi: 10.1016/j.whi.2018.12.001. Epub 2019 Jan 11.


Objectives: Our objective was to explore how mothers' attitudes and relationships with their daughters may impact the cervical cancer prevention behaviors of daughters with diverse sexual orientations.

Methods: We examined 8,143 mother-daughter dyads from the Nurses' Health Study 2 and Growing Up Today Study. During the daughter's adolescence, each mother reported her beliefs about the importance of regular Pap testing for her daughter, the frequency of communication with her daughter about Pap testing, her beliefs about Pap testing and human papillomavirus (HPV) vaccines, and her acceptance of sexual minorities (e.g., bisexuals, lesbians). Mothers and daughters separately reported relationship satisfaction. Log-binomial models were used to examine the longitudinal association between maternal factors and daughter's receipt of a Pap test and HPV vaccination.

Results: Nearly all maternal factors predicted the daughter's likelihood to have a Pap test and HPV vaccination. Higher levels of acceptance for sexual minorities and better relationship quality were also positively associated with these cervical cancer prevention behaviors. Yet, after adjusting for the maternal factors, there was little attenuation of the existing sexual orientation-related disparities in Pap tests or HPV vaccination.

Conclusions: Mothers can play an important role in their daughters' cervical cancer prevention behaviors through novel processes like being more accepting of sexual minorities and having a good relationship quality. However, in this study, maternal factors did not explain much of the sexual orientation-related disparities in cervical cancer prevention. Efforts to ensure a mother is accepting of sexual minorities and has a good relationship quality with her daughter may improve that daughter's reproductive health.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Healthcare Disparities
  • Humans
  • Middle Aged
  • Mothers / psychology*
  • Nuclear Family / psychology*
  • Papanicolaou Test / psychology*
  • Papillomavirus Vaccines*
  • Sexual Behavior / psychology*
  • Uterine Cervical Neoplasms / prevention & control*
  • Vaccination / psychology*
  • Young Adult


  • Papillomavirus Vaccines