Abstract
Human papillomavirus (hpv) infection is the cause of anal squamous cell cancer (ascc) in 80% of cases. Available research has also shown high prevalence of anal hpv infection among men who have sex with men (msm). However, hpv vaccination is low among msm in Canada. In light of this information, we conducted a scoping review with the aim of exploring (1) the knowledge of hpv and anal cancer among hiv-positive msm and (2) the acceptability of hpv and anal cancer self-sampling in this population. In conducting the review, we searched five electronic databases for peer-reviewed articles and abstracts published in English, between 2007 and 2017. A total of 803 articles were retrieved; after accounting for duplicates (n=40) and unmet criteria (n=754), a total of 794 articles were excluded. A final total of nine articles were used in this review. Results of this review show that hiv-positive msm have limited knowledge regarding the risks of anal cancer associated with hiv and hpv coinfection. Furthermore, there is limited research on hpv and anal cancer self-sampling in this population. However, the review of available studies suggested that hiv-positive msm were open to anal cancer self-sampling. It also identified potential barriers to self-sampling. In conclusion, we provide suggestions and future directions for policy-makers and educators to develop inclusive and accessible strategies to reach hiv-positive msm regarding anal cancer education and self-screening.
Highlights
Human papillomavirus infection is the cause of anal squamous cell cancer in 80% of cases[1]
Based on discussions in community think-tanks, our team decided on two research questions: (1) What has been reported on the knowledge of hpv and anal cancer among hiv-positive msm? (2) What has been reported about the acceptability of hpv and anal cancer self-sampling among hiv-positive msm? We chose to focus on hiv-positive msm because a systematic review has been conducted of msm in general[15]
Two of the three articles related to acceptability of self-sampling among hiv-positive msm were quantitative and the final study was qualitative, using semi-structured interviews to explore attitudes and barriers towards anal self-examination among hivpositive msm
Summary
Human papillomavirus (hpv) infection is the cause of anal squamous cell cancer (ascc) in 80% of cases[1]. Systematic reviews and pooled prevalence show that anal hpv infection is consistently higher among hiv-positive msm than hiv-negative msm. High-risk hpv-16 was detected in 35% of hiv-positive men and 13% of hiv-negative men, which may explain the higher rate of anal cancer incidence among hiv-positive msm (46 per 100,000 per year) than hiv-negative men (5 per 100,000 per year)[7]. Studies in Canada and elsewhere show that hpv vaccination rates among msm (outside of school-based programs) are low, ranging from 7% to 21%11-12. Other studies indicate that msm have low knowledge about hpv-related cancers[14]. A recent systematic review of 16 studies shows that the majority of msm sampled had a poor understanding of hpv and its causal role in cancer affecting them. The majority of participants did not perceive themselves as being at risk of hpv or related diseases[15]
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