Lack Of Provider Recommendation Research Articles

Mainstreaming in parallel with ovarian cancer tumor testing to improve genetic testing uptake

ObjectivesAlthough genetic testing (GT) is universally recommended for patients with epithelial ovarian cancer (EOC), rates are low (34%). In 1/2019, we implemented mainstreaming—GT in parallel with tumor testing via MSK-IMPACT within oncology clinics. We sought to determine GT rates pre/post-mainstreaming and patient characteristics associated with GT. MethodsPatients with newly diagnosed EOC seen at our institution from 7/1/2015–3/31/2022 were included. Clinical data were abstracted including social determinants of health (SDOH) variables, race/ethnicity, marital status, insurance, language, comorbidities, employment, and Yost index, a measure of socioeconomic status. GT rates were calculated overall and pre−/post-mainstreaming (1/2019). Logistic regression models were fit to identify variables associated with GT. ResultsOf 1742 patients with EOC, 1591 (91%) underwent GT. Rates of GT increased from 87% to 95% after mainstreaming (p < 0.001). Among 151 patients not undergoing GT, major reasons were lack of provider recommendation (n = 76, 50%) and logistical issues (n = 38, 25%) with few declining (n = 14, 9%) or having medical complications preventing GT (n = 7, 4.6%). High-grade serous histology, advanced stage (III/IV), and having a spouse/partner were associated with increased GT uptake (p < 0.01). Among SDOH variables, there were no differences by insurance, Yost score, language, comorbidities, employment, or race/ethnicity. In multivariable models, likelihood of GT increased with mainstreaming, even after adjustment for histology, stage, and marital status (OR 3.77; 95% CI: 2.56–5.66). ConclusionsMainstreaming increased the likelihood of GT in patients with EOC. We found lower testing rates in patients without partners/spouses, non–high-grade serous histology, and early-stage disease, representing potential areas for future interventions.

Patient perspectives on cervical cancer screening interventions among underscreened women.

Cervical cancer is highly preventable with regular screening, yet over 4,000 women die from it annually in the United States. Over half of new cervical cancer cases in the U.S. are attributable to insufficient screening. Participants were 23 low-income, uninsured or Medicaid-insured women in North Carolina who were overdue for cervical cancer screening according to national guidelines. Semi-structured interviews examined perspectives on barriers to cervical cancer screening and on interventions to reduce these barriers. We also elicited feedback on three proposed evidence-based interventions: one-on-one education, coupons to reduce out-of-pocket costs, and self-collection of samples for detection of high-risk human papillomavirus (HPV) infection, the primary cause of cervical cancer. Reported barriers included high cost, inconvenient clinic hours, lack of provider recommendation, poor transportation, difficulty finding a provider, fear of pain, and low perceived need. Participants suggested interventions including reducing cost, improving convenience through community-based screening or extended clinic hours, strengthening provider recommendations, and providing one-on-one counseling and education outreach. HPV self-collection was most frequently selected as the "most helpful" of 3 proposed interventions (n = 11), followed by reducing out-of-pocket costs (n = 7) and one-on-one education (n = 5). Cost was the most reported barrier to cervical cancer screening, although women experience multiple simultaneous barriers. Novel interventions such as HPV self-collection promise to reduce some, but not all, barriers to primary screening. Interventions that work on reducing multiple barriers, including obstacles to receiving follow-up care, may be most effective to prevent cervical cancer among these high-risk women.

Relatives from Hereditary Breast and Ovarian Cancer and Lynch Syndrome Families Forgoing Genetic Testing: Findings from the Swiss CASCADE Cohort.

Cascade genetic testing of relatives from families with pathogenic variants associated with hereditary breast and ovarian cancer (HBOC) or Lynch syndrome (LS) has important implications for cancer prevention. We compared the characteristics of relatives from HBOC or LS families who did not have genetic testing (GT (−) group) with those who had genetic testing (GT (+) group), regardless of the outcome. Self-administered surveys collected cross-sectional data between September 2017 and December 2021 from relatives participating in the CASCADE cohort. We used multivariable logistic regression with LASSO variable selection. Among n = 115 relatives who completed the baseline survey, 38% (n = 44) were in the GT (−) group. Being male (OR: 2.79, 95% CI: 1.10–7.10) and without a previous cancer diagnosis (OR: 4.47, 95% CI: 1.03–19.42) increased the odds of being untested by almost three times. Individuals from families with fewer tested relatives had 29% higher odds of being untested (OR: 0.71, 95% CI: 0.55–0.92). Reasons for forgoing cascade testing were: lack of provider recommendation, lack of time and interest in testing, being afraid of discrimination, and high out-of-pocket costs. Multilevel interventions designed to increase awareness about clinical implications of HBOC and LS in males, referrals from non-specialists, and support for testing multiple family members could improve the uptake of cascade testing.

Arab American Mothers' HPV Vaccination Knowledge and Beliefs.

Little is known of Arab Americans’ human papilloma virus vaccination (HPVV) behaviors. We explored associations between US Arab immigrant mothers’ beliefs regarding HPVV for their children with socioeconomic, medical, and religious/cultural factors. A cross-sectional survey was conducted in New York City (August 2019–April 2021) with 162 Arab American immigrant women who had at least one child aged 9 through 26 years. Among those reporting that their child/children had not received the HPVV (63.5%), reasons included not having heard of it (67.3%) and lack of provider recommendation (59.4%). HPVV awareness and uptake, respectively, were more likely among those with education ≥ 10 years (p < .001 and p < .001, respectively), with more years in the US (p < .001 and p < .001), and with higher household income (p < .001 and p = .002). Participants with limited English proficiency were less likely to have HPVV awareness and uptake (p < .001 and p < .001). Christian religious affiliation was positively associated with HPVV awareness and uptake (p = .014 and p = .048). A greater number of years in the US was significantly associated with willingness to vaccinate if recommended by the doctor (p = .031). In open-ended responses, mothers indicated that they did not receive strong provider HPVV recommendations, potentially because of their providers’ perceptions of their cultural backgrounds. Mothers indicated a desire for HPVV educational materials in Arabic to help them with decision making. Potential opportunities to augment HPVV uptake among Arab immigrants’ children include increasing population knowledge, increasing provider recommendation, and providing culturally/religiously responsive HPVV education in English and Arabic.

Levels of Parental Human Papillomavirus Vaccine Hesitancy and Their Reasons for Not Intending to Vaccinate: Insights From the 2019 National Immunization Survey-Teen

PurposeA nuanced understanding of human papillomavirus (HPV) vaccine hesitancy is key to tailoring public health interventions to reach HPV vaccination goals in the United States. We aimed to understand the spectrum of parental vaccine hesitancy and identify reasons for lack of vaccination. MethodsUsing cross-sectional data from the 2019 National Immunization Survey-Teen, we examined parents of adolescents aged 13–17 years who had not initiated HPV vaccination. Parents who did not intend to vaccinate their child in the next year were classified into three categories: “unsure,” “somewhat hesitant,” or “very hesitant.” Survey-weighted multinomial logistic regression was used to identify factors associated with level of vaccine hesitancy. ResultsOf the 13,090 parents of unvaccinated adolescents, 8,253 (63%) were hesitant. Among those, 63% were very hesitant, 29% were somewhat hesitant, and 8% were unsure. Parents who had received a provider recommendation were less likely to be unsure (adjusted relative risk ratio 0.3, 95% confidence interval 0.2–0.4) or somewhat hesitant (adjusted relative risk ratio 0.8, 95% confidence interval 0.6–0.9). Compared with non-Hispanic White parents, parents of minority race/ethnicity adolescents were more likely to be unsure versus very hesitant. Safety concerns/side effects were the most common reason for lack of intent to vaccinate among very (30%) and somewhat hesitant parents (20%), whereas lack of provider recommendation was the most common reason among unsure parents (34%). DiscussionWe identify three distinct levels of HPV vaccine hesitancy and demonstrate that the characteristics and reasons for lack of vaccination differ among these levels. Understanding a parent’s level of hesitancy may help maximize the potential impact of public health interventions to reach HPV vaccination goals.

Overcoming Barriers to Human Papillomavirus Vaccination

Introduction Despite the human papillomavirus (HPV) vaccine's ability to help prevent certain types of cancer, rates of vaccination against HPV remain low, and choosing to have a child receive the HPV vaccine has become a controversial topic. The primary objective of this quality improvement project was to increase HPV vaccination rates through creating and distributing an all-in-one education and reminder system to pediatric clinic patients and their families once patients are eligible to receive the HPV vaccination. Methods Three barriers to increasing rates of HPV vaccination were identified: cost, lack of knowledge, and lack of provider recommendation. A flyer system was implemented that addressed these barriers. This flyer was given to all patients ages 11–18 years, with a strong verbal provider recommendation. Results One-sample proportion tests were run to determine significance in the differing series completion rates in 2018, 2019, and 2020. The pediatric clinic's HPV vaccination series completion rates increased significantly from 2018 to 2019. During the implementation of this flyer system, which occurred during the COVID-19 pandemic, the vaccination series completion rates decreased, but this decrease was not statistically significant. Discussion As control is gained over the pandemic, it is anticipated that regular provider visits will increase back to normal and therefore vaccination rates will recover as well. The findings from this study can be used to create or modify current practices in clinics anywhere that the HPV vaccination is administered. Future studies and trials should be implemented for a longer period, and not during a pandemic, ideally to yield more statistically significant results.

Human papillomavirus-Inequalities in disease prevention and the impact on racial, ethnic, sexual, and gender minorities.

HPV, a sexually transmitted viral infection, is the etiological agent of significant dermatologic disease including benign anogenital warts and invasive cancers. Sexual and gender minority individuals are particularly vulnerable to HPV-associated disease due to reduced vaccination rates in these cohorts, low awareness of HPV, lack of provider recommendation, and inadequate consensus guidelines on screening and prevention in these individuals. A targeted approach is needed with regards to vaccination in all children -especially those from racial, ethnic, sexual, and gender minorities; provider recommendation, especially from pediatric dermatologists, is crucial. Effort must also be made to use transgender and non-binary affirming language as dividing vaccination programs by anatomic sex and sexuality reinforces problematic notions of gender identity and sexuality, isolating the most vulnerable.

Barriers to utilization of three colorectal cancer screening options – Data from a national survey

Colorectal cancer (CRC) screening continues to be underutilized in the United States. A better understanding of existing barriers is critical for improving uptake of, and adherence to, CRC screening. Using data from a population-based panel survey, we examined barriers to utilization of three commonly used screening options (FIT/gFOBT, mt-sDNA, and screening colonoscopy) and assessed differences by socio-demographic characteristics, healthcare access, and health status. Data were obtained from a questionnaire developed by the authors and implemented through a U.S. national panel survey conducted in November 2019. Among 5,097 invited panelists, 1,595 completed the survey (31.3%). Analyses were focused on individuals ages 50–75 at average risk for CRC. Results showed that among respondents who reported no prior CRC screening with FIT/gFOBT, mt-sDNA, or colonoscopy, the top barriers were lack of knowledge (FIT/gFOBT: 42.1%, mt-sDNA: 44.9%, colonoscopy: 34.7%), lack of provider recommendation (FIT/gFOBT: 32.1%, mt-sDNA: 27.3%, colonoscopy: 18.6%), and suboptimal access (FIT/gFOBT: 20.8%, mt-sDNA: 17.8%, colonoscopy: 26%). Among participants who had used one or two of the screening options, the top barriers to FIT/gFOBT and mt-sDNA were lack of provider recommendation (31.6% & 37.5%) and lack of knowledge (24.6% & 25.6%), while for colonoscopy top barriers were psychosocial barriers (31%) and lack of provider recommendation (22.7%). Differences by sex, race/ethnicity, income level, and health status were observed. Our research identified primary barriers to the utilization of three endorsed CRC screening options and differences by patient characteristics, highlighting the importance of improving CRC screening education and considering patient preferences in screening recommendations.

The Collaboration for Increasing Influenza Vaccination in Children (CIIVIC): a meeting report

The Collaboration for Increasing Influenza Vaccination in Children (CIIVIC): a meeting report

HPV immunisation: A review of parent and stakeholder attitudes on school-based programmes

Aim: The purpose of this integrative review is to examine the benefits of school-based human papillomavirus (HPV) vaccination programmes in improving overall vaccine education and adherence among the recommended age groups. Methods: The review explores qualitative and quantitative research published between 2010 and 2019 on benefits and barriers to HPV school-based vaccination programmes and stakeholder attitudes influencing implementation in school settings. Results: A literature review was performed from a United States perspective among ten articles revealing five themes; vaccine knowledge deficit, parental and patient hesitancy, lack of provider recommendation, vaccine safety and side effect and association with increasing sexual activity. Conclusions: HPV-associated cancers and complications are considered a public health issue. However, stakeholder attitudes on school-based HPV vaccination programmes have shown a significant gap in clinical and vaccine knowledge. Moving forward, a multi-level approach through provider training and age-based recommendations among stakeholders is key in overcoming stigmas and barriers to improve vaccination education and uptake rates.

Risk Reduction Interventions for Human Papillomavirus in Rural Maryland.

Human papillomavirus (HPV) is largely vaccine preventable. The Healthy People 2020 target goal for vaccine administration is 80%. Current United States (U. S.) rates are far lower primarily because of vaccine hesitancy and lack of provider recommendation. Implement a risk reduction initiative to increase HPV vaccine rates in females aged 12-26 in five rural counties in Maryland. A convenience sample from a rural community screened an HPV documentary movie, Questionnaire responses pre- and postscreening were surveyed for impact on vaccine readiness. Postscreening focus group comments were analyzed for common themes. Females aged 12-26 from a University Medical Group Women's Health Center located in rural Maryland were targeted. Chart review of immunization records 90 days pre- and postprovider vaccine recommendation demonstrated impact. Public awareness events have the potential to impact HPV vaccine hesitancy, but this research did not achieve statistical significance. Direct provider to patient recommendations resulted in a 15% increase in HPV immunizations. Education of vaccine-eligible individuals should be undertaken. Providers who recommend administration of the vaccine significantly increase immunization rates.

Variations in reason for intention not to vaccinate across time, region, and by race/ethnicity, NIS-Teen (2008–2016)

BackgroundHuman papillomavirus (HPV) vaccination is expected to reduce HPV-related disease and cancer in the US. However, many parents are hesitant to obtain the vaccine for their children. The purpose of this study is to examine how the reasons for refusing the HPV vaccine vary across regions of the US, across time, and by race/ethnicity. MethodsThis study used data on 13–17 year old adolescents collected by the National Immunization Survey – Teen (NIS-Teen) annually between 2008 and 2016. We evaluated the frequencies of parents who did not intend to vaccinate their children in the next year among unvaccinated children. Among these non-intenders, we evaluated how reasons for HPV vaccine hesitancy changed across time, by region of the US, and race/ethnicity. ResultsThe proportion of non-intenders among unvaccinated decreased from 72% in 2010 to 58% in 2016. The most frequent reason for vaccine hesitancy was that parents felt HPV vaccination was not necessary (22.4%), followed by lack of provider recommendation (16.2%), and lack of knowledge (15.6%). Lack of provider recommendation increased in frequency as a reason for HPV vaccine hesitancy until 2012, then decreased in frequency through 2016. Cost was one reason that was elevated in all regions compared to the Northeast. Black non-intenders were less likely to report safety, costs, or their children’s fear as reasons for not intending to vaccinate their children compared to white non-intenders. Hispanic non-intenders were more likely to report lack of knowledge and that the vaccine is not a school requirement as reasons not to vaccinate their children compared to white non-intenders. ConclusionsNational advocacy for improving provider recommendation for HPV vaccination likely contributed to a sharp decline in HPV vaccine hesitancy due to lack of provider recommendation. Results indicate the need for multifaceted interventions to increase HPV vaccination.

Prognostic understanding and barriers to palliative care in patients with metastatic lung cancer on immunotherapy.

36 Background: Communicating prognosis and integrating palliative care (PC) are challenging yet vital aspects of quality care for patients with metastatic non-small cell lung cancer (NSCLC). These tasks may be more difficult in the setting of immunotherapy, as this modality may offer a durable response but only in 10-20% of patients. Our goal was to identify correlates of prognostic understanding and interest in PC among stage IV NSCLC patients receiving immunotherapy. Methods: We conducted a cross-sectional survey of 60 patients (M age = 62.5 years; SD = 9.3 years; 40% male; 45% ≤ high school degree; 68% ECOG ≤ 1) undergoing immuno- or chemo-immunotherapy for stage IV NSCLC (80% de novo) at an academic medical center. Results: Most patients (73%) reported that knowing their prognosis was very important. Nearly all said the goal of treatment was to help them live longer (98%), feel better (95%), and completely rid them of cancer (85%); 49% thought they were likely to be cured. Only 17% of patients were interested in meeting with PC; 12% had been referred. Those patients with worse performance status (PS; ECOG 2-3) (79% vs. 35%, p = .002) and who had not yet had an appointment to assess treatment response (67% vs. 37%, p = .03) were more likely to believe they would be cured. There were no differences in expectation based on treatment response, time since diagnosis, de novo versus recurrent metastatic disease, or health literacy level. Interest in meeting with PC did not significantly differ based on expectation for cure, though only 13% of those who thought a cure was unlikely were interested in PC compared to 21% who thought a cure was likely. Patients noted multiple barriers to PC, including preference for self-management (58%), lack of provider recommendation (47%), misconceptions (e.g., PC is for people about to die; 45%), and access barriers [e.g., time (36%) and cost (24%)]. Conclusions: Many patients receiving immunotherapy for stage IV NSCLC may expect curative treatment even when they are not actually responding or have poor performance status. Efforts to improve palliative care literacy and use in this population should address PC misconceptions and emphasize its role, including how it can support self-management.

Barriers to HPV Vaccination Among Unvaccinated, Haitian American College Women.

Background: Haitian women residing in the United States are disproportionately affected by cervical cancer. Human papillomavirus (HPV) vaccine has been licensed in the United States since 2006. Vaccination rates are less than optimal overall, and the rates are particularly low among young black women. We investigated barriers to HPV vaccination in a sample of Haitian American college women.Methods: Thirty self-identified Haitian American women, aged 17−26 years, were recruited from a large university campus in southeastern United States (n=30). They completed in-depth face-to-face interviews. The research team analyzed the transcripts using thematic analysis.Results: More than half of the participants (n=18) had not yet initiated the HPV vaccine series. Most of the unvaccinated participants stated that they had received a provider recommendation for the vaccine. Lack of provider recommendation, negative vaccine perception and attitudes, and side effect concerns constituted barriers to vaccination.Conclusions: Haitian American college women at high risk of cervical cancer have cited several barriers to HPV vaccination, with the most prominent being lack of physician recommendation. Healthcare providers should continue recommending the vaccine to college women as many of them may not have received a recommendation. When recommending the HPV vaccine, discussions should be framed with the intent to positively influence HPV vaccine perceptions and ultimately vaccine attitudes.

Barriers, facilitators, and potential strategies for increasing HPV vaccination: A statewide assessment to inform action

ObjectiveThe objective was to investigate how state level strategies in South Carolina could maximize HPV vaccine uptake. DesignAn environmental scan identified barriers, facilitators, and strategies for improving HPV vaccination in South Carolina. Interviews were conducted with state leaders from relevant organizations such as public health agencies, medical associations, K-12 schools, universities, insurers, and cancer advocacy organizations. A thematic content analysis design was used. Digital interview files were transcribed, a data dictionary was created and data were coded using the data dictionary. ResultsThirty four interviews were conducted with state leaders. Barriers to HPV vaccination included lack of HPV awareness, lack of provider recommendation, HPV vaccine concerns, lack of access and practice-level barriers. Facilitators included momentum for improving HPV vaccination, school-entry Tdap requirement, pharmacy-based HPV vaccination, state immunization registry, HEDIS measures and HPV vaccine funding. Strategies for improving HPV vaccination fell into three categories: 1) addressing lack of awareness about the importance of HPV vaccination among the public and providers; 2) advocating for policy changes around HPV vaccine coverage, vaccine education, and pharmacy-based vaccination; and 3) coordination of efforts. DiscussionA statewide environmental scan generated a blueprint for action to be used to improve HPV vaccination in the state.

“My mom said it wasn't important”: A case for catch-up human papillomavirus vaccination among young adult women in the United States

The human papillomavirus (HPV) vaccine prevents HPV-related diseases, including anogenital cancers and genital warts. In the United States, while it is recommended to adolescents ages 11 to 12, catch-up vaccination is available for those previously unvaccinated until age 26. Parental decisions or lack of provider recommendation during adolescence are barriers to on-time vaccination. Young adult women, ages 18 to 26, are a key catch-up vaccination population as this is a period for autonomous decision-making, high healthcare utilization, and other recommended prevention behaviors. Additional intervention research is required to promote HPV vaccine uptake among young adult women. Evidence-based and theory-informed interventions need to be developed and evaluated to reach a large number of women. In order to improve HPV vaccination among young adult women, future research should integrate the themes of health literacy, alternative healthcare settings, and OB/GYN providers to facilitate improved access and shared decision-making for the vaccine. This last chance for HPV-related cancer prevention should not be forgotten in public health efforts.

Increasing Colorectal Cancer Screening Uptake in Patients: Provider-Initiated Discussion at Every Primary Care Patient Encounter

Colorectal cancer killed 51,651 people in the United States in 2014, despite this type of cancer being almost completely preventable and, if diagnosed in early stages, highly treatable. Colorectal cancer screening is recommended for all people 50-75 years of age at specified intervals depending on the type of screening used, as well as the screening results. However, only 58.2% of people in the United States had received appropriate screening based on their age, past screening participation, and the results of past screenings in 2013. Although patients have many barriers pertaining to uptake of colorectal cancer screening, most often cited is lack of knowledge and lack of provider recommendation. Population-based interventions are cost-effective ways of increasing the knowledge of the general public. Offering colorectal screening methods other than colonoscopy increases colorectal screening recommendation adherence. Despite these interventions, the importance of the patient-provider discussion is widely cited in the literature as a critical factor in decreasing barriers to screening and providing individualized screening recommendations with a high probability of uptake. Multiple missed opportunities exist every day within established primary care practices, and can be captured with provider-initiated discussion of colorectal cancer screening recommendations at every primary care patient encounter.

HPV Vaccine and Latino Immigrant Parents: If They Offer It, We Will Get It.

HPV vaccination rates remain low in the fast growing Latino children population while we continue to observe large HPV-associated cancer disparities in the Latino population. In this study, we sought to elucidate Latino immigrant parents' barriers to obtaining the HPV vaccine for their children. Five focus groups were conducted with Latino immigrant parents of minors (i.e., 9-17year old) who had not yet initiated the HPV vaccine series. Three major findings were identified from the focus groups: (1) low levels of awareness and knowledge of HPV and the HPV vaccine, (2) high confidence that parent can get the vaccine for their eligible child and (3) lack of provider recommendation as the main barrier to vaccination. Children of Latino immigrant parents could benefit from increased provider recommendation for the HPV vaccine while providing tailored HPV information to parents.

Update on barriers to human papillomavirus vaccination and effective strategies to promote vaccine acceptance

This article provides a clinically relevant review and analysis of the latest research regarding barriers to human papillomavirus (HPV) vaccination and strategic efforts to promote this vaccine. HPV vaccines are safe, effective, and could prevent the majority of HPV-attributable cancers, if vaccination coverage is high. However, uptake of HPV vaccine lags behind other vaccines recommended for 11 to 12-year olds. A lack of provider recommendation has consistently been found to be a key barrier to increasing vaccination rates. Lack of knowledge about the vaccine among parents coupled with an overestimation of parental vaccine hesitancy among providers also hinder vaccine uptake. Strongly recommending the vaccine as a safe, routine immunization that prevents cancer, and coadministering it with tetanus, diphtheria, and acellular pertussis vaccine and quadrivalent meningococcal conjugate vaccine, enhance vaccine uptake. In some cases, reminder and recall systems result in additional increases in vaccination rates. Recent publications reveal new information about the implementation of HPV vaccines. Provider recommendation is a key approach, as is offering it routinely at the same time as other universally recommended adolescent immunizations. With the integration of these concepts into the clinical setting, adolescents can be better protected against HPV and its associated diseases.

Abstract B72: HPV knowledge and screening among gay men of color in South Florida

Abstract Introduction: Squamous cell carcinoma of the anus (SCCA), also known as anal cancer, is on the rise, particularly among HIV-infected gay and bisexual men. The disease is caused by persistent infection of two strains of the human papillomavirus (HPV), the most common sexually transmitted infection worldwide. Persistent infection of two cancer-causing strains (16 and 18) leads to the development of high-grade squamous intraepithelial lesions (HSIL) in the anal canal which, left untreated, can develop into SCCA. Two different strains (6 and 11) cause non-cancerous genital warts, a condition more difficult to treat among HIV-infected populations. SCCA can be prevented through timely screening for HSIL via anal Papanicolau (Pap) smear or high resolution anoscopy. However, HIV-infected gay and bisexual men are continuing to suffer disproportionate burden of this disease due to various reasons included underutilization of anal cancer screening. Therefore, this study explored what HIV-infected gay and bisexual men understand about HPV, SCCA, the need to screen for this disease, and their preferences for receiving information about SCCA screening. Methods: Authors conducted in-depth interviews with 58 HIV-infected gay and bisexual men and analyzed the data using a qualitative content analysis approach. Results: Participants' HPV and SCCA awareness differed based on whether or not they had been diagnosed for either HSIL (n=3) or SCCA (n=3) compared to those who were never diagnosed for either condition. The men treated for HSIL (n=3) understood the relationship between HPV and the precancerous lesions while men diagnosed with SCCA (n=3) did not know this cancer was caused by HPV. On the other hand, men with no past diagnosis of HSIL or SCCA were not aware of HPV and its potential health repercussions. The few participants who had heard of HPV perceived the virus to be a women's health issue. Screening behaviors varied based on the clinic where participants received HIV primary care. Men who regularly received care at one specific federally qualified health center were screened for HSIL within the previous two years, and they reported that provider recommendation was the greatest facilitator that led to their screening uptake. Men receiving care at other locations or who were currently out of care did not realize the need to screen for HSIL or SCCA. They reported lack of awareness about SCCA and lack of provider recommendation to be the greatest barriers to anal cancer screening. Other barriers cited include embarrassment of screening procedures and the fear of being diagnosed with cancer. However, as men learned of their risk for cancer and upon realizing the severity of this potential diagnosis, they described their desire to screen in the near future. Participants: recommended numerous health education strategies to raise awareness about the need to screen for SCCA among HIV-infected gay and bisexual men. The most common recommendation was to ensure that HIV primary care clinicians promoted screening for HSIL and SCCA. They also recommended mass media campaigns in which educational posters and informational advertisements could be posted in public locations such as bus stops or in local print media. Conclusion: Similar to past research, HIV-infected gay and bisexual men reported willingness to screen for anal cancer, and they requested more widely communicated information about the risk for anal cancer and the need to screen. Future intervention work should use a community-based approach to raise awareness about SCCA among HIV-infected gay and bisexual men. Further, it is critical to ensure that both HIV primary care providers as well as general primary care providers promote HSIL screening, particularly among HIV-infected gay and bisexual men to prevent the development of anal cancer. Citation Format: Alexis Koskan, Natalie Leblanc. HPV knowledge and screening among gay men of color in South Florida. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B72.