Exploring anal self-examination as a means of screening for anal cancer in HIV positive men who have sex with men: a qualitative study

BMC Public Health

Christopher K Fairley³  Andrew Grulich²  Sandra Walker⁴  Marcus Chen³  Meredith Temple-Smith⁵  Jason J Ong¹ 

[1]Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010, Australia

[2]Kirby Institute, University of New South Wales, Darlinghurst, NSW 2010, Australia

[3]Central Clinical School, Monash University, Clayton, Victoria 3168, Australia

[4]Melbourne Sexual Health Centre, Carlton, Victoria 3053, Australia

[5]General Practice and Primary Health Care Academic Centre, University of Melbourne, Carlton, Victoria 3053, Australia

关键词: Men who have sex with men;    HIV;    Self-examination;    Digital ano-rectal examination;    Anal cancer;   

Others  :  1122848
DOI  :  10.1186/1471-2458-14-1257

 received in 2014-08-04, accepted in 2014-12-02,  发布年份 2014

【 摘 要 】

Background

Anal cancer is relatively common in HIV-positive men who have sex with men(MSM). However there are no clear guidelines on how to effectively screen for anal cancer. As earlier diagnosis of anal cancer is associated with increased survival, innovative ways such as utilizing anal self-examination to identify anal cancer should be explored.

Method

Semi-structured interviews were conducted with 20 HIV-positive MSM from a range of ages (35 to 78 years). This study explored acceptability and barriers to implementing ASE as a method of anal cancer screening. Framework analysis was used to identify themes.

Results

Seventeen out of 20 men had conducted an ASE before - six (35%) were for medical reasons, six (35%) for sexual reasons, three (18%) for both medical and sexual reasons, and two (12%) for cleaning purposes. Only 5 men were currently confident in detecting an abnormality. Whilst men were generally comfortable with the idea of utilizing ASE as a means for detecting anal cancer, potential barriers identified operated at three levels: attitudinal (discomfort with any anal examinations, anxiety about finding an abnormality, preference for health professional examination), knowledge (lack of awareness of anal cancer risk and ignorance of anal cancer symptoms) and practical (inadequate physical flexibility, importance of hygiene).

Conclusion

ASE may be an acceptable means for anal cancer detection in HIV-positive MSM but training in detecting abnormalities is needed. The preference for health professional examination and inadequate physical flexibility may preclude its use for some men. Future trials to confirm its wider acceptability will be needed before undertaking an effectiveness trial for detecting anal cancer.

【 授权许可】

   
2014 Ong et al.; licensee BioMed Central Ltd.

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