Exploring the Perceptions of Anal Cancer Screening and Behaviors among Gay and Bisexual Men Infected with HIV

Koskan, Alexis; Leblanc, Natalie M.; Rosa-Cunha, Isabella

doi:10.1177/107327481602300109

Cited by 26 publications

(19 citation statements)

References 19 publications

(18 reference statements)

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“…The findings also indicated the crucial role of consultations with GP in increasing participants' understanding of abnormal results, leading to a more realistic and lower cancer risk perception and moderating anxiety. This is consistent with previous results showing that primary care physicians have been reported to be the main sources of sexual health check‐up for GBM, that HIV/primary care specialists have a central role in raising awareness about the need to screen for anal cancer among HIV‐positive GBM and that physicians' recommendations are the main facilitator to screening for anal dysplasia . Further studies need to investigate whether patients with a recent connection with their healthcare providers also benefit from consultations.…”

Section: Discussionsupporting

confidence: 91%

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Experience and psychological impact of anal cancer screening in gay, bisexual and other men who have sex with men: a qualitative study

et al. 2017

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Objective: Human papillomavirus-related anal cancer rates are increasing and are particularly high in gay, bisexual and other men who have sex with men (GBM/MSM), especially HIV-positive individuals. Although screening programs for high-risk populations have been advocated, concerns about possible adverse psychological consequences exist. This study aimed to investigate GBM/MSM's experience, understanding and emotional response to screening techniques for anal cancer to determine how best to minimise psychological distress in future programs. Methods:In-depth qualitative face-to-face interviews were conducted with 21 GBM/MSM participating in the "Study of the Prevention of Anal Cancer" in Sydney, Australia, between June 2013 and June 2014. Nonrandom, purposive sampling was used to ensure heterogeneity with respect to HIV status and screening test results. Framework analysis method was used to organise the data and identify emerging themes.Results: Knowledge about anal cancer, human papillomavirus and the link between them was limited. Abnormal screening results affected participants' sense of well-being and were associated with anxiety and concern about developing anal cancer. HIV-negative men receiving abnormal results showed higher levels of distress compared to their HIV-positive counterparts. Consultations with general practitioners about abnormal results had an important role in increasing participants' understanding and in moderating their anxiety.Conclusion: Anal cancer screening should be accompanied by health education around anal cancer, its aetiology and the meaning of associated test results. Simple and effective communication strategies should be encouraged. Collaboration with general practitioners could assist the process of education and reporting test results. Recent works showed that GBM are largely unaware of the link between HPV and anal cancer, with HIV-negative men having lower awareness. 6 Lack of knowledge and recommendations from doctors are the greatest barriers to screening for HIV-positive men. The present study is explorative and pursues potentially fruitful lines of research rather than an overall explanation of the phenomenon. | Sample and recruitmentApproximately 600 men from community-based settings took part to SPANC study. 18 To be eligible, men were aged 35 years or over and reported sex with another man in their lifetime. 18 This age limit was based on the distribution of anal cancer among different age-groups and on the evidence that incidence of anal cancer increases exponentially with age. 19Among SPANC participants, men were purposively selected based on HIV status (positive and negative), age (>50 years and <50 years) and severity of screening results (normal, presence of LSIL or HSIL). Eligible participants were recruited via letter or e-mail by a SPANC research officer who had access to participants' information and contact details. The recruiting process was arm's length from the interviewer.Those who agreed to be contacted were telephoned by the interviewer t...

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Section: Discussionsupporting

confidence: 91%

“…Recent works showed that GBM are largely unaware of the link between HPV and anal cancer, with HIV‐negative men having lower awareness . Lack of knowledge and recommendations from doctors are the greatest barriers to screening for HIV‐positive men …”

Section: Introductionmentioning

confidence: 99%

Experience and psychological impact of anal cancer screening in gay, bisexual and other men who have sex with men: a qualitative study

et al. 2017

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“…In this sample, more than half of the participants had previously been screened for anal dysplasia via anal Pap smear, a higher rate than what was previously reported in another study with English-speaking populations. 33 Foreign-born Latino HIV-infected GBM noted that health-care provider recommendation alone was the driving factor for anal Pap smear completion. Therefore, it is critical that HIV primary care providers offer culturally sensitive anal dysplasia screening information for this population.…”

Section: Discussionmentioning

confidence: 99%

“…Staff from the community-based organizations posted fliers at their organizations. The fliers provided information about the topic of interest (cancer prevention), inclusion criteria (HIV-infected, self-identify as a gay or bisexual man, 18 years of age or older, fluent in Spanish [a previous study was conducted in English], 33 and resides in Miami-Dade County), and a Google number that rang directly to the bilingual research assistant’s cellphone. After potential participants called the study number, the bilingual research assistant screened them for eligibility and asked them to recommend a date, time, and location for the interview.…”

Section: Methodsmentioning

confidence: 99%

Anal Cancer Prevention Perspectives Among Foreign-Born Latino HIV-Infected Gay and Bisexual Men

Koskan

Fernández-Pineda

2018

Cancer Control

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This study explores understanding of primary and secondary prevention of anal cancer among human immunodeficiency virus (HIV)-infected foreign-born Latino gay and bisexual men (GBM). Between August 2015 and December 2016, researchers conducted 33 in-depth, semi-structured interviews with HIV-infected foreign-born Latino GBM. Interview questions sought to determine participants’ knowledge and perceived barriers and facilitators to primary and secondary prevention of anal cancer. Researchers analyzed interview transcripts using a qualitative content analysis approach. For primary prevention, men reported a lack of knowledge about the human papillomavirus (HPV) vaccine. However, for secondary prevention, roughly 60% of participants had previously screened for anal dysplasia via anal Papanicolaou (Pap) smear. However, participants reported willingness to screen, and provider recommendation was the most common screening facilitator. Men reported stigma related to their HIV status, sexual orientation, and anal Pap smear procedures as anal cancer screening barriers. Participants reported willingness to use a self-screening anal Pap smear test if it was commercially available. Health providers continue to be the leading source of health information. Therefore, provider recommendation for HPV vaccination and anal cancer screening among age-eligible foreign-born Latino HIV-infected GBM is critical. More work is needed to destigmatize HIV and sexual orientation to influence positive health behaviors among this population. Future intervention research could test the effects of provider-led interventions and also media campaigns aimed at influencing HPV vaccine uptake and anal cancer screening among this population.

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“…This may be partially attributed to lack of communication regarding anal cancer symptoms from physician to patient during the screening visit or higher levels of pain and discomfort, but there may also be a poor understanding of anal cancer risk in general among MSM. Prior studies of MSM in the United States and Australia have shown that the majority of participants were unaware of anal cancer and its associated risks and qualitatively suggested a perception that HPV-associated cancers only affected women and caused cervical cancer [27,28]. Knowledge and awareness of HPV as a risk factor for anal cancer may be even more scarce in sub-Saharan Africa where it is rarely reported in cancer registries [29].…”

Section: Discussionmentioning

confidence: 99%

Satisfaction with high-resolution anoscopy for anal cancer screening among men who have sex with men: a cross-sectional survey in Abuja, Nigeria

et al. 2020

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Background: Men who have sex with men (MSM) living with HIV are at increased risk for anal cancer. We evaluated satisfaction with first-time anal cancer screening using high resolution anoscopy (HRA) as a cross sectional survey among men who have sex with men (MSM) attending a community-engaged clinic in Abuja, Nigeria. Methods: Between March and August 2017, 342 MSM underwent screening and 307 (89%) completed a satisfaction survey that evaluated 8 domains related to expectations, convenience, staff interpersonal skills, physical surroundings, technical competence, pain/discomfort, general satisfaction, and intention to re-screen if symptomatic. The 22-item questionnaire used 5-point Likert scales ranging from 1 (strongly disagree) to 5 (strongly agree). For each domain, responses to specific items were averaged, aggregated, and converted to a 100-point scaled score (SS) with 25 and 75 corresponding to disagree and agree, respectively. Results: Median age was 24 years (interquartile range [IQR]: 22-28), median years since anal coital debut was 7 (IQR: 4-12), and 58% (95% confidence interval [CI]: 52-64%) were living with HIV. Despite respondents reporting pre-procedure anxiety (SS:73), most were comfortable with the setting and procedure and reported overall satisfaction (SS:74-76). Willingness to undergo future screening had the lowest score (SS:69) within the general satisfaction domain. The lowest scoring domains were pain/discomfort (SS:57) and agreement to re-screen if symptomatic (SS:59), which correlated with lower overall satisfaction (p < 0.001). Domain responses did not differ by HIV infection after adjusting for multiple comparisons (p > 0.006) or number of anal biopsies (all p > 0.05). Conclusions: Overall, HRA was satisfactory for those naïve to screening but moving forward necessitates monitoring levels of discomfort with pain scales and normalizing dialogue around clinical symptoms of anal cancer and overall anal health to sustain future screening.

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Exploring the Perceptions of Anal Cancer Screening and Behaviors among Gay and Bisexual Men Infected with HIV

Cited by 26 publications

References 19 publications

Experience and psychological impact of anal cancer screening in gay, bisexual and other men who have sex with men: a qualitative study

Experience and psychological impact of anal cancer screening in gay, bisexual and other men who have sex with men: a qualitative study

Anal Cancer Prevention Perspectives Among Foreign-Born Latino HIV-Infected Gay and Bisexual Men

Satisfaction with high-resolution anoscopy for anal cancer screening among men who have sex with men: a cross-sectional survey in Abuja, Nigeria

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