The influence of home versus clinic anal human papillomavirus sampling on high-resolution anoscopy uptake in the Prevent Anal Cancer Self-Swab Study. medRxiv 2023 Dec 29
Date
01/18/2024Pubmed ID
38234718Pubmed Central ID
PMC10793519DOI
10.1101/2023.12.27.23300457Abstract
BACKGROUND: Anal cancer disproportionately affects men who have sex with men (MSM) living with HIV. High-resolution anoscopy (HRA) is an in-clinic procedure to detect precancerous anal lesions and cancer, yet prospective data on factors associated with HRA attendance are lacking. We examined whether anal HPV sampling at home versus in a clinic impacts HRA uptake and assessed HRA acceptability.
METHOD: MSM and trans persons 25 years and older were randomized to home-based self-sampling or clinical sampling. All were asked to attend in-clinic HRA one year later. We regressed HRA attendance on study arm using multivariable Poisson regression and assessed HRA acceptability using χ 2 tests.
RESULTS: 62.8% of 196 participants who engaged in screening attended HRA. Although not significant ( p =0.13), a higher proportion of participants who engaged in clinic-based screening attended HRA (68.5%) compared to home-based participants (57.9%). Overall, HRA uptake was higher among participants with anal cytology history (aRR 1.44, 95% CI 1.11 - 1.87) and lower among participants preferring versatile anal sex position versus insertive (aRR 0.70, 95% CI 0.53 - 0.91), but did not differ by race or HIV serostatus. In the clinic arm, persons living with HIV had lower HRA attendance (42.9%) versus HIV-negative participants (73.3%) ( p =0.02) and Black non-Hispanic participants had lower HRA attendance (41.7%) than White non-Hispanic participants (73.1%), ( p =0.04); however, no differences in attendance by race or HIV status were observed in the home arm.
CONCLUSIONS: HRA uptake differed significantly by race and HIV status in the clinic arm but not the home arm.
Author List
Nitkowski J, Ridolfi TJ, Lundeen SJ, Giuliano AR, Chiao E, Fernandez ME, Schick V, Smith JS, Brzezinski B, Nyitray AGAuthors
Sarah J. Lundeen NP APP Outpatient in the Surgery department at Medical College of WisconsinAlan Nyitray PhD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Timothy J. Ridolfi MD, MS, FACS Associate Professor in the Surgery department at Medical College of Wisconsin
