Background Persons with HIV (PWH) at highest risk of anal cancer include gay, bisexual, and other men who have sex with men (GBMSM) and transgender women aged ≥ 35 years, and other PWH aged ≥ 45 years. Identifying and treating precancerous lesions can reduce anal cancer incidence in these groups. We assessed prevalence of anal cytology and access to high-resolution anoscopy (HRA) among PWH, overall and those at highest risk. Methods Data were obtained from the CDC’s Medical Monitoring Project (MMP), a population-based survey of PWH aged ≥ 18 years, and a supplemental MMP facility survey. We report weighted percentages of PWH receiving anal cytology during the past 12 months, access to HRA, and characteristics of HIV care facilities by availability of HRA. Results Overall, 4.8% (95% CI 3.4 to 6.1) of PWH had anal cytology in the prior 12 months. Only 7.7% (95% CI 5.1 to 10.6) of GBMSM and transgender women aged ≥ 35 years, and 1.9% (95% CI 0.9 to 2.9) of all other PWH aged ≥ 45 years, had anal cytology. Prevalence was statistically significantly low among PWH with the following characteristics: non-Hispanic/Latino Black/African American, ≤ high school education, heterosexual orientation, and living in Southern MMP states. Among PWH, 32.8% (95% CI 28.0 to 37.7) had no HRA access on-site/through referral at their care facility; 22.2% (95% CI 19.5 to 24.9) had on-site access; 45.0% (95% CI 41.5 to 48.5) had HRA available through referral. Most facilities that received Ryan White HIV/AIDS Program funding, cared for > 1000 PWH, or provided on-site colposcopy also provided HRA on-site/through referral. Conclusions Anal cytology and access to HRA was low among PWH, including those at highest risk of anal cancer. Our data may inform large-scale implementation of anal cancer prevention efforts.

中文翻译：

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艾滋病毒感染者肛门细胞学筛查的流行率以及艾滋病毒护理机构缺乏高分辨率肛门镜检查的机会

背景 肛门癌风险最高的艾滋病毒感染者（PWH）包括同性恋、双性恋和其他男男性行为者（GBMSM）和年龄≥35岁的变性女性，以及其他年龄≥45岁的PWH。识别和治疗癌前病变可以降低这些人群的肛门癌发病率。我们评估了感染者和高危人群中肛门细胞学检查的普及率以及高分辨率肛门镜检查 (HRA) 的普及率。方法 数据来自 CDC 的医疗监测项目 (MMP)、一项针对 18 岁以上 PWH 的人口调查以及一项补充 MMP 设施调查。我们报告了过去 12 个月内接受肛门细胞学检查的感染者的加权百分比、HRA 的使用情况以及按 HRA 的可用性划分的 HIV 护理设施的特征。结果 总体而言，4.8%（95% CI 3.4 至 6.1）的感染者在过去 12 个月内接受过肛门细胞学检查。只有 7.7%（95% CI 5.1 至 10.6）的年龄 ≥ 35 岁的 GBMSM 和变性女性以及所有其他年龄 ≥ 45 岁的 PWH 中的 1.9%（95% CI 0.9 至 2.9）进行了肛门细胞学检查。具有以下特征的 PWH 中的患病率在统计学上显着较低：非西班牙裔/拉丁裔黑人/非裔美国人、≤ 高中教育、异性恋取向以及居住在南部 MMP 州。在 PWH 中，32.8%（95% CI 28.0 至 37.7）无法现场/通过其护理机构转介获得 HRA 访问； 22.2%（95% CI 19.5 至 24.9）有现场访问权限； 45.0%（95% CI 41.5 至 48.5）通过转诊获得了 HRA。大多数接受瑞安·怀特艾滋病毒/艾滋病计划资助的设施都得到了照顾> 1000 PWH，或提供现场阴道镜检查，也提供 HRA 现场/通过转诊。结论 PWH 中肛门细胞学检查和 HRA 获取率较低，包括肛门癌风险最高的人群。我们的数据可以为大规模实施肛门癌预防工作提供信息。