BI14 Photoprotection and skin cancer awareness in kidney transplant recipients living with HIV: a single-centre cross-sectional study

Abstract

Abstract Kidney transplant recipients (KTRs) are up to 65 times more likely to develop nonmelanoma skin cancers than age-matched general populations. HIV has also been associated with increased skin cancer rates. However, to date, there has been no study evaluating photoprotection and skin cancer awareness in KTRs living with HIV (KTRLHIV). Using validated photoprotection and skin cancer awareness questionnaires, we evaluated knowledge and practices in KTRLHIV and an HIV-negative KTR cohort, matched for age, sex, ethnicity and years since transplant. KTRLHIV (n = 27) and matched HIV-negative KTRs (n = 25) completed the questionnaires. Thirty-four (65%) were male and 37 (71%) were Black. The average age was 56 years (range 43–74). On average, patients were 7.3 years post-transplant (range 0.7–24). Twenty-two (81%) KTRLHIV vs. 15 (60%) matched HIV-negative KTRs had not seen a dermatologist in the last year. Only 14 (52%) KTRLHIV had received sun protection advice vs. 20 (80%) of the matched KTRs (P = 0.033). There were statistically significant lower rates of overall sunscreen use in KTRLHIV compared with matched HIV-negative KTRs (33% vs. 60%; P = 0.054). Only a small proportion used sunscreen daily (22% vs. 27%), of a sun protection factor > 25 (78% vs. 100%). A strongly positive tetrachoric correlation coefficient of 0.77 indicated that providing photoprotection advice correlates to sunscreen use. Significantly lower rates of photoprotection behaviours were seen in the KTRLHIV compared with HIV-negative KTRs, particularly never avoiding direct sunlight (59% vs. 16%; P = 0.001) and never dressing to protect from the sun (52% vs. 12%; P = 0.002). We have identified statistically significant lower knowledge of photoprotection and skin cancer awareness in KTRLHIV vs. matched HIV-negative KTRs. Lower rates of skin cancer protection advice may have resulted in lower rates of sunscreen use and poorer photoprotection behaviours in KTRLHIV. A dedicated skin cancer awareness education to promote patient-led skin cancer prevention alongside formal dermatology referral is recommended.