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

Abstract

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.

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

“…This internalized stigma among participants is also indicated as a barrier in studies that followed the same methodology. 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.…”

Facilitators and Barriers to Take Up Clinician-Collected and Self-Collected HPV Tests among Chinese Men Who Have Sex with Men

“…In the literature, the prevalence of HPV tests uptake was low among MSM, ranging from 11–14.3% among MSM in general [ 24 , 25 ] to 40–60% among HIV-positive MSM [ 26 , 27 , 28 ]. To our knowledge, at least five quantitative studies investigated factors associated with HPV tests uptake among MSM [ 24 , 25 , 27 , 28 , 29 ].…”

“…Perceptions had significant influences on HIV and other sexually transmitted infections (STI) screening behaviors among MSM, and they are modifiable through interventions [ 30 , 31 , 32 ]. Qualitative studies suggested that perceived stigma originated from service providers related to their sexual orientation or HIV sero-status; barriers for MSM to receive HPV tests included embarrassment and discomfort, fear of positive results, and perceived low risk of anal cancers [ 26 , 33 , 34 ]. These factors were considered by this study.…”

“…Self-collected HPV tests have been shown to have similar accuracy as clinician-collected tests [ 36 ]. Two studies showed high acceptance of self-collected HPV tests among MSM (67–78%) [ 26 , 37 ]. MSM perceived self-collected HPV tests to be convenient and would lower the embarrassment and fear of being stigmatized [ 26 , 37 ].…”

A eficácia no rastreio do câncer anal através da avaliação retrospectiva de resultados de citologia anal relacionados a dados demográficos e infecções virais intercorrentes

“…Também é relevante destacar que a prevenção primária com a vacina contra o HPV é fundamental para evitar as lesões de alto grau e o câncer anal, principalmente em países com rastreio limitado e numerosos pacientes infectados por HIV. 39,40 Considerações em relação ao comportamento sexual de risco também devem ser feitas, já que o câncer anal está diretamente ligado à atividade sexual anal, sendo possível que os pacientes omitam dados ou neguem a prática do sexo anal, especialmente porque o sexo anal ainda é muito estigmatizado na sociedade. 41 A citologia anal é um exame simples, sensível e bem tolerado pelos pacientes, além de oferecer informações valiosas sobre as lesões préneoplásicas, auxiliando a discriminar quem serão os pacientes submetidos à anoscopia associada ao estudo histológico.…”