The influence of home versus clinic anal human papillomavirus sampling on high-resolution anoscopy uptake in the Prevent Anal Cancer Self-Swab Study

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The Prevent Anal Cancer Self-Swab Study

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. 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 randomly assigned to home-based self-sampling or clinical sampling. All were asked to attend in-clinic HRA 1 year later. We analyzed HRA attendance and acceptability.

Results

62.8% of 196 participants who engaged in screening attended HRA. A higher proportion of participants who engaged in clinic-based screening attended HRA (68.5%) compared to home-based participants (57.9%). HRA uptake was higher among participants with anal cytology history and lower among participants preferring a versatile anal sex position versus insertive. In the clinic arm, persons living with HIV had lower HRA attendance versus HIV-negative participants, and Black non-Hispanic participants had lower HRA attendance than White non-Hispanic participants. 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.

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