Skip to main content

Advertisement

SpringerLink
Log in

Healthy behavioral choices and cancer screening in persons living with HIV/AIDS are different by sex and years since HIV diagnosis

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

The prevalence of non-AIDS-related malignancies is on the rise among people aging with HIV population, but the evidence on healthy behaviors including cancer screening practices in this population subgroup is extremely limited. Therefore, we investigated the prevalence of healthy behaviors and sex-specific cancer screening among persons living with HIV, by sex and time since HIV diagnosis.

Methods

We included 517 persons living with HIV from the Florida Cohort. Data were obtained from the baseline and follow-up questionnaires, electronic medical records, and Enhanced HIV/AIDS Reporting System. The prevalence of self-reported, age-appropriate cancer screening (anal, colorectal, prostate, breast, and cervical), and healthy behaviors (sustaining healthy body weight, refraining from smoking and alcohol and engaging in physical activity) was compared by sex and years since HIV diagnosis (≤ 13 vs. > 13 years).

Results

In the analyses by sex, females were more likely to be obese than males (56.5% vs. 22.2%, p < 0.0001). Distribution of healthy behaviors did not differ by time since diagnosis among males and females. In the analysis of age-appropriate screening among males, 64.8% never had an anal Pap-smear, 36.2% never had a colonoscopy, and 38.9% never had prostate cancer screening. In the analysis of age-appropriate screening among females, 50.0% never had an anal Pap-smear, 46.5% never had a colonoscopy, 7.9% never had a cervical Pap-smear, and 12.7% never had a mammogram. The difference in anal Pap-smear by sex was statistically significant (p < 0.0001). Among males, the age-adjusted prevalence of never having a colonoscopy was higher in those who had HIV for ≤ 13 years (50.8% vs. 30.6%, p = 0.03).

Conclusion

The prevalence of selected healthy behaviors and cancer screening differed by sex and/or years since HIV diagnosis suggesting a need for tailored cancer prevention efforts among persons living with HIV via long-term sex-specific interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Chirch LM, Hasham M, Kuchel GA (2014) HIV and aging: a clinical journey from Koch’s postulate to the chronic disease model and the contribution of geriatric syndromes. Curr Opin HIV AIDS 9:405–411

    Article  PubMed  Google Scholar 

  2. Deeks SG, Lewin SR, Havlir DV (2013) The end of AIDS: HIV infection as a chronic disease. Lancet 382:1525–1533

    Article  PubMed  PubMed Central  Google Scholar 

  3. Risher KA, Kapoor S, Daramola AM, Paz-Bailey G, Skarbinski J, Doyle K, Shah M (2017) Challenges in the evaluation of interventions to improve engagement along the HIV care continuum in the United States: a systematic review. AIDS Behav 21:2101–2123

    Article  PubMed  PubMed Central  Google Scholar 

  4. Centers for Disease Control and Prevention. HIV among people aged 50 and over. HIV/AIDS age 2017. https://www.cdc.gov/hiv/group/age/olderamericans/. Accessed 10 Apr 2018

  5. Parka LSH-RR, Silverberg MJ, Crothers KA, Dubrow R (2016) Prevalence of non-HIV cancer risk factors in persons living with HIV/AIDS. AIDS 30:273–291

    Article  CAS  Google Scholar 

  6. Shiels MS, Engels EA (2017) Evolving epidemiology of HIV-associated malignancies. Curr Opin HIV AIDS 12:6–11

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Coghill AE, Engels EA, Schymura MJ, Mahale P, Shiels MS (2018) Risk of breast, prostate, and colorectal cancer diagnoses among HIV-infected individuals in the United States. J Natl Cancer Inst 110:959–966

    Article  PubMed  PubMed Central  Google Scholar 

  8. Patel P, Hanson DL, Sullivan PS et al (2008) Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992–2003. Ann Intern Med 148:728–736

    Article  PubMed  Google Scholar 

  9. Shiels MS, Islam JY, Rosenberg PS, Hall HI, Jacobson E, Engels EA (2018) Projected cancer incidence rates and burden of incident cancer cases in HIV-infected adults in the United States through 2030. Ann Intern Med 168:866–873

    Article  PubMed  PubMed Central  Google Scholar 

  10. Presti C, Haslinger M, Wehner P (2017) Breast cancer in HIV-positive patients: a multi-institutional retrospective review. J Prev Med Healthc 1(2):1009

    Google Scholar 

  11. Silberstein J, Downs T, Lakin C, Kane CJ (2008) HIV and prostate cancer: a systematic review of the literature. Prostate Cancer Prostatic Dis 12:6

    Article  PubMed  Google Scholar 

  12. Gomez A, Montero AJ, Hurley J (2015) Clinical outcomes in breast cancer patients with HIV/AIDS: a retrospective study. Breast Cancer Res Treat 149:781–788

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Sigel C, Cavalcanti MS, Daniel T, Vakiani E, Shia J, Sigel K (2016) Clinicopathologic features of colorectal carcinoma in HIV-positive patients. Cancer Epidemiol Biomarkers Prev 25:1098–1104

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Robbins HA, Pfeiffer RM, Shiels MS, Li J, Hall HI, Engels EA (2015) Excess cancers among HIV-infected people in the United States. J Natl Cancer Inst. https://doi.org/10.1093/jnci/dju503

    Article  PubMed  PubMed Central  Google Scholar 

  15. Colditz GA, Wolin KY, Gehlert S (2012) Applying what we know to accelerate cancer prevention. Sci Transl Med 4:127rv4

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T (2012) American Cancer Society guidelines on nutrition and physical activity for cancer prevention. Cancer J Clin 62:30–67

    Article  Google Scholar 

  17. US Department of Veteran Affairs 2016. HIV/AIDS primary care manual 2011. https://www.hiv.va.gov/provider/manual-primary-care/index.asp. Accessed 15 Dec 2018

  18. Park B, Kong S-Y, Kim J, Kim Y, Park IH, Jung S-Y, Lee ES (2015) Health behaviors of cancer survivors in nationwide cross-sectional survey in Korea: higher alcohol drinking, lower smoking, and physical inactivity pattern in survivors with higher household income. Medicine 94:e1214–e1214

    Article  PubMed  PubMed Central  Google Scholar 

  19. Naik H, Qiu X, Brown MC, Eng L, Pringle D, Mahler M, Hon H, Tiessen K, Thai H, Ho V, Gonos C, Charow R, Pat V, Irwin M, Herzog L, Ho A, Xu W, Jones JM, Howell D, Liu G (2016) Socioeconomic status and lifestyle behaviours in cancer survivors: smoking and physical activity. Curr Oncol 23:e546-e555

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nayak P, Paxton RJ, Holmes H, Thanh Nguyen H, Elting LS (2015) Racial and ethnic differences in health behaviors among cancer survivors. Am J Prev Med 48:729–736

    Article  PubMed  Google Scholar 

  21. National Research Council (US) Panel on race, ethnicity, and health in later life; Anderson NB, Bulatao RA, Cohen B, editors. Critical perspectives on racial and ethnic differences in health in late life. Washington (DC): National Academies Press (US) 12, Racial/ethnic disparities in health behaviors: a challenge to current assumptions (2004). https://www.ncbi.nlm.nih.gov/books/NBK25518/

  22. Yaghjyan L, Wolin K, Chang S-H, Colditz G (2014) Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005. Cancer Causes Control 25:605–614

    Article  PubMed  PubMed Central  Google Scholar 

  23. Nunez-Rocha GM, Wall KM, Chavez-Peralta M, Salinas-Martinez AM, Benavides-Torres RA (2013) Nutritional care, time period since diagnosis, demographics and body mass index in HIV/AIDS patients. Rev Invest Clin 65:291–299

    PubMed  Google Scholar 

  24. Friedemann-Sánchez G, Griffin JM, Partin MR (2007) Gender differences in colorectal cancer screening barriers and information needs. Health Expect 10:148–160

    Article  PubMed  PubMed Central  Google Scholar 

  25. Yager SS, Chen L, Cheung WY (2014) Sex-based disparities in colorectal cancer screening. Am J Clin Oncol 37:555–560

    Article  PubMed  Google Scholar 

  26. Lucero RJ, Frimpong JA, Fehlberg EA, Bjarnadottir RI, Weaver MT, Cook C, Modave F, Rathore MH, Morano JP, Lbanez G, Cook RL (2017) The relationship between individual characteristics and interest in using a mobile phone app for HIV self-management: observational cohort study of people living with HIV. JMIR mHealth uHealth 5(7):e100

    Article  PubMed  PubMed Central  Google Scholar 

  27. Nebraska D of Health and human services. eHARS (Enhanced HIV/AIDS Reporting System). 2017. http://dhhs.ne.gov/publichealth/DataCenter/Pages/eHARS.aspx. Accessed 10 Apr 2018

  28. Centers for Disease Control and Prevention. About adult BMI 2017. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html. Accessed 10 Apr 2018

  29. U.S. Department of Health and Human Services aUSDoA, (2015) Dietary guidelines for Americans 2015–2020. 6th edn. U.S. Government Printing Office, Washington, DC

    Google Scholar 

  30. Wolf AMD, Fontham ETH, Church TR, Flowers CR, Guerra CE, LaMonte SJ, Etzioni R, McKenna MT, Oeffinger KC, Shih Y-CT, Walter LC, Andrews KS, Brawley OW, Brooks D, Fedewa SA, Manassaram-Baptiste D, Siegel RL, Wender RC, Smith RA (2018) Colorectal cancer screening for average-risk adults: 2018 guideline update from the American cancer society. Cancer J Clin. 68:250–281

    Article  Google Scholar 

  31. American Cancer Society guidelines for the early detection of cancer (2018) https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-societyguidelines-for-the-early-detection-of-cancer.html. Accessed 10 Apr 2018

  32. Leeds IL, Fang SH (2016) Anal cancer and intraepithelial neoplasia screening: a review. World J Gastrointest Surg 8:41–51

    Article  PubMed  PubMed Central  Google Scholar 

  33. Sigel K, Dubrow R, Silverberg M, Crothers K, Braithwaite S, Justice A (2011) Cancer screening in patients infected with HIV. Curr HIV/AIDS Rep 8:142–152

    Article  PubMed  PubMed Central  Google Scholar 

  34. Mellors JW, Munoz A, Giorgi JV, Margolick JB, Tassoni CJ, Gupta P, Kingsley LA, Todd JA, Saah AJ, Detels R, Phair JP, Rinaldo CR (2017) Plasma viral load and CD4+ lymphocytes as prognostic markers of HIV-1 infection. Ann Intern Med 126:946–954

    Article  Google Scholar 

  35. Bauer UE, Briss PA, Goodman RA, Bowman BA (2014) Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. Lancet 384:45–52

    Article  PubMed  Google Scholar 

  36. Smith RA, Brooks D, Cokkinides V, Saslow D, Brawley OW (2013) Cancer screening in the United States, 2013. Cancer J Clin 63:87–105

    Article  Google Scholar 

  37. Aserlind A, Maguire K, Duthely L, Wennin S, Potter J (2017) Women living with HIV over Age of 65: cervical cancer screening in a unique and growing population. Infect Dis Obstet Gynecol. https://doi.org/10.1155/2017/2105061

    Article  PubMed  PubMed Central  Google Scholar 

  38. Bryan L, Westmaas L, Alcaraz K, Jemal A (2014) Cigarette smoking and cancer screening underutilization by state: BRFSS 2010. Nicotine Tob Res 16:1183–1189

    Article  CAS  PubMed  Google Scholar 

  39. Mu L, Mukamal KJ (2016) Alcohol consumption and rates of cancer screening: is cancer risk overestimated? Cancer Causes Control 27:281–289

    Article  PubMed  Google Scholar 

  40. Mdodo R, Frazier EL, Dube SR, Mattson CL, Sutton MY, Brooks JT, Skarbinski J (2015) Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys. Ann Intern Med 162:335–344

    Article  PubMed  Google Scholar 

  41. Wells JS, Holstad MM, Watkins Bruner D (2017) Sociodemographic predictors of anal cancer screening and follow-up in human immunodeficiency virus-infected individuals. Cancer Nurs 41:424–430

    Article  Google Scholar 

  42. Brooks JT, Buchacz K, Gebo KA, Mermin J (2017) HIV infection and older Americans: the public health perspective. Am J Public Health. 102:1516–26

    Article  Google Scholar 

  43. Swendeman D, Ingram BL, Rotheram-Borus MJ (2009) Common elements in self-management of HIV and other chronic illnesses: an integrative framework. AIDS Care 21:1321–1334

    Article  PubMed  PubMed Central  Google Scholar 

  44. Schoenborn CA, Adams PF, Peregoy JA (2013) Health behaviors of adults: United States, 2008–2010. Vital Health Stat 10:1–184

    Google Scholar 

  45. Goedert JJ, Hosgood HD, Biggar RJ, Strickler HD, Rabkin CS (2016) Screening for cancer in persons living with HIV infection. Trends Cancer 2:416–428

    Article  PubMed  PubMed Central  Google Scholar 

  46. US Department of Health and Human Services. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents 2018. https://aidsinfo.nih.gov/contentfiles/lvguidelines/glchunk/glchunk_343.pdf. Accessed 10 Jan 2019

  47. Xu J, Zhou H (2017) Screening for anal cancer in HIV positive patients: should we make it a standard-of-care? J Invest Surg. https://doi.org/10.1080/08941939.2017.1369608

    Article  PubMed  Google Scholar 

  48. US Department of Veteran Affairs (2018) Anal dysplasia: primary care of veterans with HIV. U.S. Department of Veterans Affairs, Washington DC. https://www.hiv.va.gov/provider/manual-primary-care/anal-dysplasia.asp

    Google Scholar 

  49. Meissner HI, Breen N, Klabunde CN, Vernon SW (2006) Patterns of colorectal cancer screening uptake among men and women in the United States. Cancer Epidemiol Biomarkers Prev 15(2):389–394

    Article  PubMed  Google Scholar 

  50. Chao A, Connell CJ, Cokkinides V, Jacobs EJ, Calle EE, Thun MJ (2011) Underuse of screening sigmoidoscopy and colonoscopy in a large cohort of US adults. Am J Public Health. https://doi.org/10.2105/AJPH.94.10.1775

    Article  Google Scholar 

  51. Marcus JL, Chao CR, Leyden WA, Xu L, Klein DB, Horberg MA, Towner WJ, Quesenberry CP Jr, Abrams DI, Van Den Eeden SK, Silverberg MJ (2014) Prostate cancer incidence and prostate-specific antigen testing among HIV-positive and HIV-negative men. J Acquir Immune Defic Syndr 66:495–502

    Article  PubMed  Google Scholar 

  52. National Center for Health Statistics Health, United States (2017) Health, United States (2016): with chartbook on long-term trends in health. National Center for Health Statistics, Hyattsville

    Google Scholar 

  53. US Department of Health and Human Services (2017) Seeing your health care provider: managing your appointments. https://www.hiv.gov/hiv-basics/staying-in-hiv-care/provider-visits-and-lab-test/seeing-yourhealth-care-provider. Accessed 10 Jan 2019

  54. Mutasa-Apollo T, Ford N, Wiens M, Socias ME, Negussie E, Wu P, Popoff E, Park J, Mills EJ, Kanters S (2017) Effect of frequency of clinic visits and medication pick-up on antiretroviral treatment outcomes: a systematic literature review and meta-analysis. J Int AIDS Soc 20:21647

    Article  PubMed  PubMed Central  Google Scholar 

  55. Ferrante JM, Ohman-Strickland P, Hahn KA, Hudson SV, Shaw EK, Crosson JC, Crabtree BF (2008) Self-report versus medical records for assessing cancer-preventive services delivery. Cancer Epidemiol Biomarkers Prev 17:2987–2994

    Article  PubMed  PubMed Central  Google Scholar 

  56. Simons JS, Wills TA, Emery NN, Marks RM (2015) Quantifying alcohol consumption: self-report, transdermal assessment, and prediction of dependence symptoms. Addict Behav 50:205–212

    Article  PubMed  PubMed Central  Google Scholar 

  57. Norman A, Bellocco R, Bergstrom A, Wolk A (2001) Validity and reproducibility of self-reported total physical activity–differences by relative weight. Int J Obes Relat Metab Disord 25:682–688

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by NIAAA (Grant No. U24 AA022002 and U24AA020003), and from the State of Florida via the University of Miami Miller School of Medicine Institute for AIDS and Emerging Infectious Diseases. The Enhanced HIV/AIDS Reporting System data were provided from the HIV data center, Infectious Disease Surveillance Division, Florida Department of Health.

Author information

Authors and Affiliations

  1. Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, 2004 Mowry Road, PO Box 100321, Gainesville, FL, 32610-0231, USA

    Akemi T. Wijayabahu, Zhi Zhou, Robert L. Cook & Lusine Yaghjyan

  2. Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, USA

    Babette Brumback

  3. Department of Clinical and Health Psychology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, USA

    Nicole Ennis

Authors
  1. Akemi T. Wijayabahu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhi Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert L. Cook
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Babette Brumback
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nicole Ennis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lusine Yaghjyan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lusine Yaghjyan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This study was approved by the University of Florida, Florida International University, and the Florida Department of Health Institutional Review Boards (IRBs). All participants provided written informed consent.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wijayabahu, A.T., Zhou, Z., Cook, R.L. et al. Healthy behavioral choices and cancer screening in persons living with HIV/AIDS are different by sex and years since HIV diagnosis. Cancer Causes Control 30, 281–290 (2019). https://doi.org/10.1007/s10552-019-1135-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-019-1135-3

Keywords

Search

Navigation