(351) Examining Sexual Well-Being in Cis-Gendered, HIV- Positive African American Women at-risk for Anal Cancer
Authors: Mpanu-Mpanu R , Suarez B , Goldsmith B , Duthely L 
Published: February 2024

Abstract

Introduction
Although considered to be relatively rare in women, the prevalence of anal cancer is high among persons living with HIV. According to the CDC, cis-gendered Black women accounted for 91% of all new HIV infections in the U.S., with the greatest concentration being in the Southern United States (U.S.). Anal cancer poses significant emotional, social, and physical challenges, with potential implications for their sexual health and overall well-being. The State of Florida, located in the Southern U.S. has one of the highest rates of anal cancer in the country. Our objective is to explore the intersection between anal cancer risk, depression and women’s sexual well-being, highlighting the various psychological factors that may influence quality of life and sexual function. Sexual dysfunction and anal cancer are both addressed late among Black women, compared to non-Hispanic White women. Anal cancer as well as sexual dysfunction decrease quality of life, and as black women are at a higher risk of both, it is imperative to address these two conditions in this specific population. An intervention is proposed, therefore, to implement an adaptation of an evidenced-based, online intervention that improves psychological well-being for a population of cis-gendered Black women with HIV.

Objective
The primary outcome of this pilot study is to assess intervention feasibility/acceptability in a clinic-based population of Black women with HIV, living in South Florida, co-diagnosed with ano-genital dysplasia. Secondary outcomes are to assess intervention effectiveness on depression, quality of life, and sexual well-being.

Methods
Baseline demographic profile (age, ethnicity), behavioral health (alcohol, smoking and illicit drug use), gynecological profile, depressive symptoms and sexual well-being will be collected for a total of N=30, cis-gendered women of Black race, with HIV. The online intervention will be conducted over a two-month period. Three months post-baseline, participants will be measured regarding depressive symptoms and sexual well-being. Chi-square or Fisher's Exact will compare categorical variables, and T-Tests will compare pre-intervention to post-intervention means. Given the exploratory nature of this study, significance will be assessed at p&lt;0.10.

Results
Results Pending.

Conclusions
The current treatment options for anal cancer have a significant impact on women’s sexual well-being. Options for treatment include chemotherapy, radiation, and various surgical procedures. Women are oftentimes left in pain and discomfort from these procedures, leading to uncomfortable sexual intercourse as well as altered bowel function. Chemotherapy/radiation also contributes to increased fatigue, hormonal imbalances, and body image changes. All these factors have been found to decrease sexual desire. In addition, the literature points to significant, negative, change in psychological status, for women undergoing anal cancer treatment. Findings will elucidate the potential for the intervention to improve well-being among this population of women with HIV, at-risk for anal cancer.

Disclosure
No.