Adequacy and Acceptability of the Self-Collected Anal Pap Smear in People Living With Human Immunodeficiency Virus in the Infectious Diseases Clinic

Background Anal Pap smears are imperative to screening for human papillomavirus (HPV)-associated anal squamous cell cancers, particularly in patients living with human immunodeficiency virus (HIV) given a higher incidence of disease. Self -collection of specimens may be favored by patients and more feasible to collect, increasing screening. Methods This was a single -center observational cohort study at a single academic medical center Infectious Diseases clinic from October to December 2021. We aimed to improve compliance of anal Pap collection documentation of "self -collected" versus "physician -collected" as well as verify if self -collected specimens (SCS) were adequate for interpretation equivalent to physician -collected specimens (PCS). Additionally, we aimed to evaluate patient and provider satisfaction with self -collected anal Paps. Results Sixty anal Pap smears were available for evaluation. The rate of documentation of the collection method (self -collected vs. physician -collected) was 88% during the intervention. A total of 75% of patients opted for self -collection, and 35/45 (78%) of these samples were adequate for interpretation. There was no difference in the adequacy of specimen (the ability of a cytopathologist to interpret the specimen) between the SCS and PCS. Conclusion Limited prior data suggest self -collected anal Pap specimens are adequate for interpretation only slightly less often than PCS. In our small cohort, there was no statistically significant difference between collection methods. Satisfaction with self -collection of specimens was high for both patients and providers. Additional validation in more diverse/larger clinical settings may be helpful to support this practice.