Online Program

HIV Comes First: Perspectives on Cancer Screening Utilization among Men Living with HIV/AIDS

Monday, November 2, 2015

Shalanda A. Bynum, PhD, MPH, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD
Mariannah Kitandwe, MPH, Preventive Medicine and Biometric, Henry Jackson Foundation, Bethesda, MD
Faith Fletcher, PhD, MA, Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL
Jelani Kerr, PhD, School of Public Health and Information Sciences, University of Louisville, Louisville, KY
Kenneth Granville, Capital Medical Associates, Washington, DC
Theo W. Hodge Jr., MD, Capital Medical Associates, Washington, DC
Michael W. Plankey, PhD, Department of Medicine / Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC
Background: Men living with HIV/AIDS (MLH) have a long established history of bearing an excess burden of AIDS-defining malignancies and are disproportionately impacted by certain non-AIDS defining cancers. Although reduced immune function may play a role in cancer development, gaps in cancer screening may also contribute to increased morbidity/mortality. Thus, the purpose of this study was to understand MLH perspectives related to cancer screening utilization.

Methods: Theoretically guided by the Behavioral Model for Vulnerable Populations, 20 face-to-face qualitative interviews were conducted to understand predisposing, enabling, and need-for-care factors related to cancer screening utilization among MLH attending a community medical practice in Washington, DC. Data were analyzed using Qualitative Content Analysis technique.

Results: The majority of participants were African American/Black (n=14), non-Hispanic (n=18), mean age=45±8.86 years, mean time since HIV/AIDS diagnosis=14±8.03 years. About half of participants reported ever hearing about cancer development among MLH. Although most participants were concerned personally about cancer, HIV disease management was the primary concern. Two predisposing themes emerged regarding the propensity of MLH to utilize cancer screenings: positive experiences with the healthcare system and beliefs that screening can prevent death. Four enabling themes emerged related to the ability of MLH to engage in cancer screenings: awareness/knowledge, healthcare access, integration of health services, and provider relationship/recommendation. Maintaining a good quality of life overall, and more specifically psychological and financial stability emerged as need-for-carethemes.

Conclusions: Medical and public health efforts to improve cancer prevention and control outcomes among MLH should focus on awareness/knowledge, health beliefs, and healthcare system factors.

Learning Areas:

Assessment of individual and community needs for health education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the disproportionate burden of cancer experienced by men living with HIV/AIDS. Describe the benefits of using a theoretical framework to understand cancer screening utilization among men living with HIV/AIDS. Identify predisposing, enabling, and need-for-care factors related to cancer screening utilization among men living with HIV/AIDS.

Keyword(s): Cancer and Men’s Health, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My research focuses broadly on addressing psychosocial, behavioral, and contextual factors that impact reproductive and cancer-related disparities among disadvantaged women living with HIV/AIDS. My dissertation and postdoctoral research studies were competitively funded by the Centers for Disease Control (R36) and the National Cancer Institute R25T Post-doctoral Fellowship in Cancer Prevention, respectively. I am currently a fellow of The Fordham University HIV Prevention Research Ethics Training Institute sponsored by the National Institute on Drug Abuse.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.