A Community-Based Approach to Enhancing Anal Cancer Screening in Hawaii's HIV-Infected Ethnic Minorities
- *Corresponding Author:
- Bruce Shiramizu, MD
Departments of Pediatrics
Medicine and Tropical Medicine
John A. Burns School of Medicine
651 Ilalo St., BSB 325
Honolulu, Hawaii, USA
Tel: (808) 692-1677
Fax: (808) 692-1984
E-mail: [email protected]
Received Date: June 15, 2012; Accepted Date: July 10, 2012; Published Date: July 13, 2012
Citation: Shiramizu B, Milne C, Terada K, Cassel K, Matsuno RK, et al. (2012) A Community-Based Approach to Enhancing Anal Cancer Screening in Hawaii’s HIVInfected Ethnic Minorities. J AIDS Clinic Res 3:162. doi:10.4172/2155-6113.1000162
Copyright: © 2012 Shiramizu B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Disparities in anal cancer incidence among Hawaii’s HIV-infected minority population is an emerging health concern. Although anal cytology/anoscopy are effective anal cancer screening tools, social barriers exist that prevent individuals from seeking appropriate care. Design: Community based participatory research (CBPR) principles were applied to develop resources, including testing a self-obtained anal specimen procedure, to increase anal cancer screening among Hawaii’s underserved/ minority populations.
Methods: A team of community members, academic researchers, and health care providers developed culturally-sensitive educational/recruitment materials regarding anal cancer risk targeting underserved/minority HIVinfected individuals. Self- and health care provider (HCP)-obtained anal cancer screening specimens were reviewed for cytology and tested for human papillomavirus DNA. A follow-up evaluation elicited feedback on attitudes and experiences.
Results: Community discussion sessions identified key messages about anal cancer, anal cancer screening, and HPV infection for materials and were used, that successfully recruited 46 individuals (38 males/8 females; 9 Native Hawaiians/Pacific Islanders/Asians, 2 Blacks, 6 Hispanics, 6 American Indian/Alaskan Natives, 23 Whites). Concordance in cytology results between self- and HCP-obtained specimens was moderated (kappa=0.37) with the perception that the self-obtained specimen procedure was private (93%), safe (100%), and easy to manage (100%); and a majority (92%) willing to use the self-obtained method again.
Conclusions: CBPR was a practical approach in engaging Hawaii’s HIV-infected minority participation in anal cancer screening research. Community outreach and recruitment efforts suggested that self-obtained screening specimens could be an acceptable and effective means to reach Hawaii’s HIV-infected ethnic minorities.