Engagement and Factors Associated With Annual Anal Human Papillomavirus Screening Among Sexual and Gender Minority Individuals

Authors

• Jenna Nitkowski
• Timothy J Ridolfi
• Sarah J Lundeen
• Anna R Giuliano
• Elizabeth Chiao
• Maria E Fernandez
• Vanessa Schick
• Jennifer S Smith
• Paige Bruggink
• Bridgett Brzezinski
• Alan G Nyitray

Language

English

Publication Date

2-1-2025

Journal

Sexually Transmitted Diseases

DOI

10.1097/OLQ.0000000000002084

PMID

39316041

PMCID

PMC11711006

PubMedCentral® Posted Date

2-1-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Although self-sampling could help address anal cancer screening barriers, no studies have investigated annual engagement with this method or compared it with annual screening with a provider. Building on our baseline article, we compared annual anal screening engagement between home-based self-sampling and clinic-based clinician sampling.

Methods: The Prevent Anal Cancer Self-Swab Study recruited and randomized sexual and gender minority individuals 25 years and older who have sex with men to a home or clinic arm. Home-based participants were mailed an anal human papillomavirus self-sampling kit at baseline and 12 months, whereas clinic-based participants were asked to schedule and attend 1 of 5 participating clinics at baseline and 12 months. Using Poisson regression, we conducted an intention-to-treat analysis of 240 randomized participants who were invited to screen at both timepoints.

Results: More than half (58.8%) of participants completed annual (median = 370 days) anal screening. In the home arm, 65.0% of participants engaged in annual screening compared with 52.5% of clinic-based participants ( P = 0.049). When stratified by HIV status, persons living with HIV had a higher proportion of home (71.1%) versus clinic (22.2%) annual screening ( P < 0.001). Non-Hispanic Black participants participated more in home-based annual anal screening (73.1%) than annual clinic screening (31.6%; P = 0.01). Overall, annual screening engagement was significantly higher among participants who had heard of anal cancer from an LGBTQ organization, reported "some" prior anal cancer knowledge, preferred an insertive anal sex position, and reported any prior cancer diagnosis.

Conclusions: Annual screening engagement among those at disproportionate anal cancer risk was higher in the home arm.

Keywords

Humans, Male, Papillomavirus Infections, Sexual and Gender Minorities, Female, Anus Neoplasms, Adult, Middle Aged, Early Detection of Cancer, Mass Screening, Anal Canal, Homosexuality, Male, Papillomaviridae, Patient Acceptance of Health Care, Human Papillomavirus Viruses

Published Open-Access

yes

Recommended Citation

Nitkowski, Jenna; Ridolfi, Timothy J; Lundeen, Sarah J; et al., "Engagement and Factors Associated With Annual Anal Human Papillomavirus Screening Among Sexual and Gender Minority Individuals" (2025). Faculty, Staff and Student Publications. 1426.
https://digitalcommons.library.tmc.edu/uthsph_docs/1426