Anal Cancer and Anal Cancer Screening Knowledge, Attitudes, and Perceived Risk Among Women Living With HIV

J Low Genit Tract Dis. 2021 Jan 1;25(1):43-47. doi: 10.1097/LGT.0000000000000578.


Objectives: The aims of the study were (1) to describe anal cancer knowledge, perceived risk, screening barriers, and acceptability of sample self-collection among women living with HIV (WLWH) at an integrated safety-net system and (2) to describe differences in demographic and psychosocial variables among a subsample of WLWH with a history of abnormal cervical cytology results versus those with normal results.

Materials and methods: We conducted telephone surveys with English- and Spanish-speaking WLWH (N = 99) and used electronic health record data to extract insurance type, CD4+ cell count, RNA viral load, and cervical cytology results. We calculated descriptive statistics for participant demographics, HIV laboratory results, and psychosocial variables. Among the subsample of women who completed a recent cervical Pap, we used Fisher exact test to assess differences in demographic variables, CD4+ counts, RNA viral loads, knowledge, awareness, acceptability, and perceived risk by cervical cytology results.

Results: Most participants (70%) reported knowing nothing about anal cancer; 28% correctly responded that HIV increases one's chance of getting anal cancer. Most (68%) never heard of an anal Pap test. Forty percent would get an anal Pap if they could self-collect the sample, whereas 59% were neutral or disagreed. The 2 most commonly cited barriers to obtaining an anal Pap were "I do not know enough about it" (n = 15) and "It might hurt" (n = 9).

Conclusions: This study highlights a gap in knowledge and awareness among WLWH regarding their heightened risk for anal cancer. It indicates the need for health education and suggests an opportunity for a self-collection intervention.

MeSH terms

  • Adolescent
  • Adult
  • Anus Neoplasms / diagnosis*
  • Anus Neoplasms / psychology*
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / psychology*
  • Female
  • HIV Infections / psychology*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Middle Aged
  • Papanicolaou Test / psychology
  • Risk Factors
  • Texas
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / psychology
  • Young Adult