Acceptability of high‐resolution anoscopy for anal cancer screening in <scp>HIV</scp>‐infected patients

Lam, Jennifer O; Barnell, Gregory M.; Ellis, Courtney; Silverberg, MJ

doi:10.1111/hiv.12663

Cited by 18 publications

(22 citation statements)

References 32 publications

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“…8,9 ACSC survey respondents rated the potential benefit of clinic attendance to their health very positively, similar to previous studies showing high patient satisfaction with anal dysplasia screening and evaluation. 10 No-show rates in the ACSC were comparatively low for an inner-city clinic, supporting patient acceptance of the service. The majority of survey respondents reported learning about anal dysplasia and AC in their physician’s office and had fair knowledge of risk factors, but an analysis of the referral patterns to the ACSC from individual HIV providers suggested that not all consistently perform AC screening; this observation is also supported by the low proportion of survey respondents reporting prior DARE and anal cytology screening.…”

Section: Discussionmentioning

confidence: 89%

Establishing an Anal Cancer Screening Program in an Outpatient HIV Clinic: Referral Patterns and Patient Perceptions Survey

Sowah

Schmalzle

Khambaty

et al. 2020

J Int Assoc Provid AIDS Care

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People living with HIV are at high risk for anal cancer (AC); however, the impact of screening for and treatment of precancerous anal lesions on AC incidence remains uncertain. In 2013, we conducted a survey of HIV providers evaluating the perceived need for an institutional AC screening program. Based on an overwhelmingly positive response, we established a dedicated AC screening clinic (including provision of high-resolution anoscopies) embedded within the institutional HIV clinic. Here, we describe that referral of high-risk patients in the first 3 years was lower than expected. Referral patterns suggest that screening practices vary widely among HIV providers within the institution. Anal cancer clinic patients who completed a perception survey rated the value of AC screening as high, with perceived positive health impact, and identified their providers as the main source of information on AC and AC screening. Our findings imply remaining provider-related barriers to AC screening.

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Section: Discussionmentioning

confidence: 89%

Establishing an Anal Cancer Screening Program in an Outpatient HIV Clinic: Referral Patterns and Patient Perceptions Survey

Sowah

Schmalzle

Khambaty

et al. 2020

J Int Assoc Provid AIDS Care

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“…While anal cancer screening has recently been shown to be acceptable to persons living with HIV, 26 , 41 multiple barriers to accessing such care have been documented. 28 , 42 , 43 These barriers may also be more significant among lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons.…”

Section: Introductionmentioning

confidence: 99%

“That’s Only for Women”: The Importance of Educating HIV-Positive Sexual Minority Men on HPV and High Resolution Anoscopy (HRA)

Finneran

Peretz

Blemur

et al. 2021

J Int Assoc Provid AIDS Care

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Gay, bisexual, and other men who have sex with men (MSM) experience disproportionately high burdens of Human Papilloma Virus (HPV)-associated anal cancers. Recent focus has shifted to anorectal cancer prevention through high-resolution anoscopy (HRA); however, little is known about sexual minority men’s perceptions, attitudes, or beliefs regarding HRA. We conducted 4 qualitative Focus Group Discussions (FGDs) (n = 15) with sexual minority men, focusing on their beliefs, attitudes, and perceptions of undergoing HRA. Participants discussed their experiences of HPV/HRA as influenced by both their gender and sexuality, including unawareness of HPV disease as a male health issue, challenges relating to female-oriented HPV/HRA language, conception of HPV/HRA as related to prostate health, and connecting their sexual behavior identification as “bottoms” to their need for HRA. As efforts to improve HRA knowledge, access, and uptake among sexual and gender minority communities increase, special attention should be paid to language and messaging choices around HRA.

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“…25,26 The acceptability questionnaire indicated that 62.5% of the participants did not feel discomfort during the exam, which corroborates data found in the literature describing high tolerability between MSM and men living with HIV/AIDS, especially at the time of performing HRA. [27][28][29] All participants reported that they would undergo the proctological examination again if necessary. One study obtained similar results: 100% of patients who completed their survey stated that they would return for a follow-up HRA if recommended.…”

Section: Discussionmentioning

confidence: 99%

“…One study obtained similar results: 100% of patients who completed their survey stated that they would return for a follow-up HRA if recommended. 27 These factors are important considerations for the caregivers of these patients, particularly during preprocedure counseling. [27][28][29][30] According to the present data, HIV transmission occurred mainly through sexual intercourse, and 40.7% had more than ten years of infection.…”

Section: Discussionmentioning

confidence: 99%

“…27 These factors are important considerations for the caregivers of these patients, particularly during preprocedure counseling. [27][28][29][30] According to the present data, HIV transmission occurred mainly through sexual intercourse, and 40.7% had more than ten years of infection. The natural history of anal dysplasia in the HIV-positive population is known to present a faster progression from LGAII to HGAII in these patients when compared with the general population; the rate of progression from HGAII to ASCC at five years is also higher.…”

Section: Discussionmentioning

confidence: 99%

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Anal cancer screening in a high-risk behavior group: A local picture

Rabelo

Oliveira

Melo

et al. 2020

Journal of Coloproctology

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Study objectives To perform anal lesion and anal cancer screening in men living with HIV/AIDS. Methods This is a descriptive, observational, cross-sectional study. Data were obtained from the Specialized Assistance Service (SAE) in Divinópolis, Minas Gerais. A sociodemographic, epidemiological, and sexual behavior questionnaire was applied; material was collected for cytology, high-resolution anoscopy (AAR) was performed, and an acceptability questionnaire applied. Main results Of the 50 men living with HIV/AIDS invited to participate in this study, 6% were excluded because they were illiterate, 40% refused to participate, and 54% participated in the survey. Among these, all answered the self-administered questionnaire. However, ten (37.0%) underwent proctological examination and anal cytology. Of these, two did not respond to the acceptability questionnaire. No anal lesions were identified during AAR and no biopsy was required. A 10% change in anal cytology was found. Conclusions Through the study it was possible to construct a flow of referrals from the SAE to the UFSJ Coloproctology outpatient clinic. Moreover, the existence of internal stigmas on the part of the participants regarding the proctological examination and the lack of information about anal cancer screening are challenges to be overcome.

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Acceptability of high‐resolution anoscopy for anal cancer screening in HIV‐infected patients

Abstract: HRA was generally well tolerated and may be an acceptable screening approach for patients at high risk of anal cancer.

Cited by 18 publications

References 32 publications

Establishing an Anal Cancer Screening Program in an Outpatient HIV Clinic: Referral Patterns and Patient Perceptions Survey

Establishing an Anal Cancer Screening Program in an Outpatient HIV Clinic: Referral Patterns and Patient Perceptions Survey

“That’s Only for Women”: The Importance of Educating HIV-Positive Sexual Minority Men on HPV and High Resolution Anoscopy (HRA)

Anal cancer screening in a high-risk behavior group: A local picture

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