title: Uptake and predictors of anal cancer screening in men who have sex with men.
abstract: OBJECTIVE
  We investigated attitudes about and acceptance of anal Papanicolaou (Pap) screening among men who have sex with men (MSM).
  
  
  METHODS
  Free anal Pap screening (cytology) was offered to 1742 MSM in the Multicenter AIDS Cohort Study, who reported history of, attitudes about, and experience with screening. We explored predictors of declining screening with multivariate logistic regression.
  
  
  RESULTS
  A history of anal Pap screening was uncommon among non-HIV-infected MSM, but more common among HIV-infected MSM (10% vs 39%; P < .001). Most participants expressed moderate or strong interest in screening (86%), no anxiety about screening (66%), and a strong belief in the utility of screening (65%). Acceptance of screening during this study was high (85%) across all 4 US sites. Among those screened, most reported it was "not a big deal" or "not as bad as expected," and 3% reported that it was "scary." Declining to have screening was associated with Black race, anxiety about screening, and low interest, but not age or HIV status.
  
  
  CONCLUSIONS
  This study demonstrated high acceptance of anal Pap screening among both HIV-infected and non-HIV-infected MSM across 4 US sites.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health Department of Epidemiology, Baltimore, MD 21205, USA. gdsouza@jhsph.edu
authors.forename: Gypsyamber
authors.initials: G
authors.lastname: D'Souza
authors.forename: Shirani D
authors.initials: SD
authors.lastname: Rajan
authors.forename: Rohini
authors.initials: R
authors.lastname: Bhatia
authors.forename: Ross D
authors.initials: RD
authors.lastname: Cranston
authors.forename: Michael W
authors.initials: MW
authors.lastname: Plankey
authors.forename: Anthony
authors.initials: A
authors.lastname: Silvestre
authors.forename: David G
authors.initials: DG
authors.lastname: Ostrow
authors.forename: Dorothy
authors.initials: D
authors.lastname: Wiley
authors.forename: Nisha
authors.initials: N
authors.lastname: Shah
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
mesh_terms: D000328:Adult; D001005:Anus Neoplasms / Q000175:diagnosis*; D001294:Attitude to Health; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology