Awareness and knowledge of anal cancer in a community-recruited sample of HIV-negative and HIV-positive gay and bisexual men.

ABSTRACT

Background Anal cancer disproportionately affects people with HIV infection, especially gay and bisexual men (GBM). The awareness and understanding of human papillomavirus (HPV) and anal cancer in a community-based sample of people living with HIV and GBM was explored to inform future evidence-based public health interventions. METHODS: Following consultation with affected communities and relevant healthcare professionals, a questionnaire was developed that assessed knowledge, understanding and experience of anal HPV, HPV vaccination, screening and perceived personal risk of anal cancer. Participants were recruited through HIV community and GBM organisations and anonymously completed the questionnaire online. RESULTS: Of 1660 questionnaires returned, 1574 were analysed from men, of whom 1535 (97.5%) identified as GBM and 15.7% reported being HIV-positive. Most (51.8%) of the HIV-positive men and 68.1% of HIV-negative or unknown men thought their risk of anal cancer was the same, or lower, than that of the general population. Only a small minority (12.5%) reported ever having talked to their doctor about anal HPV and/or anal cancer and 11.6% reported ever having had an anal cancer examination. Less than one-third (31.5%) had heard of HPV vaccination and only 2.9% of men recollected receiving HPV vaccination. CONCLUSIONS: Knowledge and awareness of anal cancer was generally poor in a sample of HIV-positive and HIV-negative GBM. Specific information targeted at these people could potentially raise awareness, leading to earlier diagnosis, reduced burden of disease among GBM and less demands on the healthcare system. Young GBM might benefit from education regarding the importance of HPV vaccination.