Gay and Bisexual Men′s Willingness to Receive Anal Pap Testing

Objectives. We sought to characterize the willingness of men who have sex with men (MSM) to receive anal Pap tests, because these men have high rates of anal cancer that may be prevented through regular screening.

Methods. We surveyed a national sample of men aged 18-59 who self-identified as gay (n=236) or bisexual (n=70).

Results. Few men were willing to receive anal Pap tests not paid for by insurance, but most would accept free screening (31% vs. 83%, McNemar's χ²=158.02, ρ<.001). Willingness to pay for screening was higher among men who reported greater worry about getting anal cancer (OR=1.70, 95%CI=1.06, 2.72), higher perceived likelihood of anal cancer (OR=1.88, 95%CI=1.18, 2.99), and higher income (OR=2.17, 95%CI=1.18, 3.98), in adjusted analyses. Only 33% (17/51) of human immunodeficiency virus (HIV)-positive men, who have the highest risk for anal cancer, had previously received anal Pap tests.

Conclusions. Anal cancer screening was highly acceptable to MSM, although cost was a major barrier. Modifiable beliefs associated with anal Pap test acceptability provide targets for future efforts to reduce anal cancer disparities among MSM relative to heterosexual men.