Introduction High-risk oncogenic types of human papillomavirus (HPV) are the major cause of several cancers in men, notably anal cancer. HIV co-infection further elevates risk. We assessed knowledge of and attitudes regarding HPV, HPV vaccination, anal cancer, and anal cancer screening among HIV-positive men.

Methods Male participants of a multi-site cohort of persons in care at 9 specialty HIV clinics in Ontario, Canada, responded to questions about HPV knowledge and attitudes regarding perceived risk and willingness to receive HPV vaccine and anal cancer screening. We analysed data from interviews between 04/2016 and 08/2016.

Results 678 men were interviewed. Many had either not heard of HPV (20%) or had heard the term but did not know what it was (25%). Among men familiar with the term (n=398), only 51% knew that HPV can cause anal cancer and 56% knew that people with HIV are at higher risk for cancers caused by HPV. Many thought their chance of getting HPV was zero (19%) or low (36%). 63% had heard of the HPV vaccine and 44% knew that it was recommended for males, but only 13% reported that a health professional discussed the vaccine with them and 6% were vaccinated. Men said that they would be likely/very likely to get vaccinated if it were offered free of charge (81%), if they had to co-pay $30/dose (59%), or pay full price (18%). The majority would be likely/very likely to get anal cancer screening via digital rectal exam (87%), Pap cytology (90%), or anoscopy (83%). Men were comfortable/very comfortable discussing anal health with their HIV doctor (87%) and family doctor (84%).

Conclusion Our findings suggest that there are many knowledge gaps to address regarding awareness of HPV and HPV-associated disease among HIV-positive men, but that men were comfortable discussing anal health with care providers. Men were generally willing to accept anal cancer screening and HPV vaccination, if offered at no/low cost. Future work will identify correlates of hesitancy to accept vaccination and screening, which can guide promotional messaging and interventions.