Jenna Nitkowski, Timothy J. Ridolfi, Sarah J. Lundeen, Anna R. Giuliano, Elizabeth Y. Chiao, Maria E. Fernandez, Vanessa Schick, Jennifer S. Smith, Bridgett Brzezinski, Alan G. Nyitray
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引用次数: 0
Abstract
Background
Anal cancer disproportionately affects sexual and gender minority individuals 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.
Methods
Sexual and gender minority individuals were randomised to home-based self-sampling or clinical sampling. All were asked to attend in-clinic HRA 1 year later. We regressed HRA attendance on study arm using multivariable Poisson regression and assessed HRA acceptability using χ2 tests.
Results
A total of 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 1.40, 95% CI 1.07–1.82), and lower among participants preferring a 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). 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.
背景肛门癌对感染艾滋病毒的性少数群体和性别少数群体的影响尤为严重。高分辨率肛门镜检查(HRA)是一种在诊所内检测肛门癌前病变和癌症的方法,但目前还缺乏关于HRA就诊相关因素的前瞻性数据。我们研究了在家与在诊所进行肛门 HPV 采样是否会影响 HRA 的接受率,并评估了 HRA 的可接受性。方法:性取向和性别少数群体被随机分配到家庭自我采样或临床采样。要求所有患者在 1 年后参加门诊 HRA。我们使用多变量泊松回归法将 HRA 出席率与研究臂进行回归,并使用 χ2 检验评估 HRA 的可接受性。结果 在参与筛查的 196 名参与者中,共有 62.8% 参加了 HRA。尽管差异不显著(P = 0.13),但参加诊所筛查的参与者参加 HRA 的比例(68.5%)高于参加家庭筛查的参与者(57.9%)。总体而言,有肛门细胞学检查史的参与者接受 HRA 的比例更高(aRR 为 1.40,95% CI 为 1.07-1.82),而倾向于肛交体位的参与者接受 HRA 的比例低于插入式(aRR 为 0.70,95% CI 为 0.53-0.91),但不同种族或 HIV 血清状态的参与者接受 HRA 的比例没有差异。在诊所治疗组中,HIV 感染者的 HRA 出席率(42.9%)低于 HIV 阴性参与者(73.3%)(P = 0.02),黑人非西班牙裔参与者的 HRA 出席率(41.7%)低于白人非西班牙裔参与者(73.1%)(P = 0.04)。在家庭治疗组中,没有观察到不同种族或艾滋病病毒感染状况的参加率差异。结论 在诊所治疗组,不同种族和 HIV 感染状况的 HRA 接受率存在显著差异,而在家庭治疗组则没有。
期刊介绍:
Sexual Health publishes original and significant contributions to the fields of sexual health including HIV/AIDS, Sexually transmissible infections, issues of sexuality and relevant areas of reproductive health. This journal is directed towards those working in sexual health as clinicians, public health practitioners, researchers in behavioural, clinical, laboratory, public health or social, sciences. The journal publishes peer reviewed original research, editorials, review articles, topical debates, case reports and critical correspondence.
Officially sponsored by:
The Australasian Chapter of Sexual Health Medicine of RACP
Sexual Health Society of Queensland
Sexual Health is the official journal of the International Union against Sexually Transmitted Infections (IUSTI), Asia-Pacific, and the Asia-Oceania Federation of Sexology.