Grant: T. Gr.: Embracing Diversity -HIV/AIDS/STBBI-Co-infections and Co-morbidities-LOI

The goal of the HPV-EQ Team is to prevent anal cancer, a preventable disease caused by infection with human papillomavirus (HPV). People living with HIV and gay, bisexual, and other men who have sex with men (GBM) are at particularly high risk compared to the general public. Prevention using HPV vaccination works best when people get vaccinated as an adolescent. We need new evidence to know whether vaccination when a person is older will also work, or if another approach may be better. Screening for anal cancer, like we with do for cervical cancer, could save lives and is now recommended in new clinical guidelines. It is time to explore implementation of anal screening in ways that prioritize people living with HIV and GBM who are at the highest risk. Access to prevention should be fair, no matter people's gender identity, sexual orientation, race, or where they live. We will gather evidence in three projects. First, we will estimate how well HPV vaccines work among GBM according to their age, HIV status, and how long they have been sexually active. Second, we will explore equity needs for anal screening implementation by speaking with people living with HIV, healthcare providers, and decision-makers in provincial health systems. Third, we will find out whether new screening tests might do a better job identifying who is at the highest risk for anal cancer, so that they are advanced to the front of the line for full assessment and treatment, if needed. The HPV-EQ Team has much expertise to carry out these projects. It includes frontline leaders and advocates in health services delivery for people living with and at risk of HIV/STBBI. Altogether, our work will provide the evidence on how to effectively and equitably prevent anal cancer among GBM and people living with HIV.