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.
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By:
- 1University of Hawai'i-Ma-noa, Honolulu, HI, USA University of Hawai'i Cancer Center, Honolulu, HI, USA lskaopua@hawaii.edu.
- 2University of Hawai'i Cancer Center, Honolulu, HI, USA.
- 3University of Hawai'i-Ma-noa, Honolulu, HI, USA University of Hawai'i Cancer Center, Honolulu, HI, USA.
- 4University of Hawai'i-Ma-noa, Honolulu, HI, USA.
- 5Life Foundation of O'ahu, Honolulu, HI, USA.
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