GYN when necessary, and 47% of respondents stated that their problems became worse in the time that they had to wait. In one extreme case, Sara, a woman incarcerated in New York, had to wait seven months before she was finally diagnosed with an aggressive cancer. Another woman had to wait four months to receive a colposcopy, a follow-up to her Pap test. Another woman at the same prison wrote: In a qualitative study on the experiences of incarcerated women with the Papanicolaou test (a test which screens for cervical cancer) in California state prisons, researchers found a lack of communication between medical providers within the prison, which tended to result in long delays or cancellations of treatment, no standardized process for scheduling a Pap test, and a lack of education and explanation regarding both the test itself, and how to fill out the medical forms associated with it. In addition to this, women who aren't called in for a Pap test are sometimes required to pay a $5 fee if they request one. This can be a significant barrier to requesting a test, considering an average prisoner's wage is around 7 to 13 cents per hour. In the same study, women brought attention to the discomfort suffered by inmates with personal histories of sexual abuse and victimization when they were forced to be examined by a male physician. Women interviewed in New York State prisons had similar complaints about their physicians' seeming lack of awareness of female prisoners' past traumas, and the lack of explanation of the procedures. One woman stated: Perceptions of Medical Care Another consideration in correctional reproductive health care is the relationship between the prisoner-patients and the physicians. Studies have shown that female inmates often report distrust of physicians and disappointment with their interactions with providers. Researchers have found that most of the women interviewed in the 2005 California state prison study had negative perceptions of their gynecologic tests and treatment. According to the women interviewed, the prison doctors who performed their tests were often unprofessional and disrespectful. One woman described her experience, saying: "They expect us to give them respect, but they don't respect us. They treat us like we are animals just because we are incarcerated." The California prison system employs corrections officers who are also trained to be licensed nurses (called medical technical assistants). Similarly, in Chicago, the county jails train corrections officers