Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan;17(1):21-30.
doi: 10.1177/1524839915615611. Epub 2015 Dec 2.

Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

Lana Sue I Ka'opua  1 , Kevin Cassel  2 , Bruce Shiramizu  3 , Rebecca L Stotzer  4 , Andrew Robles  4 , Cathy Kapua  5 , Malulani Orton  5 , Cris Milne  4 , Maddalynn Sesepasara  5
Affiliations

Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

Lana Sue I Ka'opua et al. Health Promot Pract. 2016 Jan.

Abstract

Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales.

Keywords: HIV; Native Hawaiians/Pacific Islanders; anal cancer screening; cancer disparities; cultural competence; sexual minorities.

PubMed Disclaimer

Figures

Figure 1
Figure 1
G rounded Theory: Overarching Theme and Core Categories
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Airhihenbuwa CO. Health and culture: Beyond the Western paradigm. Thousand Oaks, CA: Sage; 1995. - PubMed
    1. American Cancer Society. Anal cancer detailed guide. 2014 Retrieved from http://www.cancer.org/acs/groups/cid/documents/webcontent/003083-pdf.pdf.
    1. Burkhalter JE, Cahill S, Shuk E, Guidry J, Corner G, Berk A, Lubetkin EI. At the intersection of HIV/AIDS and cancer: A qualitative needs assessment of community-based HIV/AIDS service organizations. Health Education Behavior. 2013;40:493–503. - PMC - PubMed
    1. Gates GJ, Newport F. LGBT percentage highest in D.C., lowest in North Dakota. 2013 Retrieved from http://www.gallup.com/poll/160517/lgbt-percentage-highest-lowest-north-d....
    1. Gierisch JM, DeFrank JT, Bowling JM, Rimer BK, Matuszewski JM, Farrell D, Skinner CS. Finding the minimal intervention needed for sustained mammography adherence. American Journal of Preventive Medicine. 2010;39:334–344. - PMC - PubMed

Publication types

MeSH terms