Pilot Award

Incidence of anal cancer is more than eighty times higher in HIV-infected men who have sex with men (MSM) than in the HIV-uninfected population. Because the majority of these patients are diagnosed in the early stages and early anal cancer typically responds well to concurrent chemoradiation, research on long-term survivorship in this population is a growing yet unmet need. Sexual dysfunction is one of the most common and distressing consequences of anal cancer treatment. While acute toxicities of concurrent chemoradiation for anal cancer are fairly well-described, the long-term effects of the treatment on overall quality-of-life and sexual health has not been investigated. In particular, there is a dearth of qualitative research addressing sexual health issues in anal cancer survivors who are HIV-infected MSM. To improve the quality of survivorship care in anal cancer, the sexual health needs of patients require assessment and treatment. Furthermore, despite the preponderance of descriptive evidence about sexual problems for survivors, there is often little communication about sexuality between survivors and clinicians. We propose to conduct semi-structured, 1-on-1 interviews with oncologic care providers and HIV-infected MSM who have completed chemoradiation for anal cancer at least 6 months ago and currently have no evidence of disease. The proposed pilot study will elucidate the limitations of current communication practices and collect data needed to develop communication strategies that foster effective sexual health counseling with HIV-infected MSM after anal cancer treatment. The contribution of the proposed research will be to document the effect of anal cancer treatment on quality of provider-patient communication regarding sexual health of HIV-infected MSM. Results of this project can also serve as an impetus for developing targeted psychosocial and survivorship support services for these patients.