Abstract PO-024: Survivorship care plan for cancer prevention and screening for people living with HIV (PLWH)
Authors: Gillespie Theresa W. , Mincey Loree , Liu Yuan , Ballard Denise , Scott Kimberly W. , Knott Robert , Nguyen Minh Ly T. , Chawla Saurabh , Lipscomb Joseph , Wells Jessica H. 
Published: January 2022

Abstract
BACKGROUND. Over 1.2 million people living with HIV (PLWH) in the US are aging, many with the chance for normal or near-nomal life expectancy. Yet PLWH are at significantly increased risk for non-AIDS associated cancers due to immunocompromise, antiretroviral medications, lifestyle factors, and social determinants of health issues. HIV disproportionately affects Blacks, those from lower socioeconomic status, the uninsured, and the Southern US. Outcomes from PLWH diagnosed wtih cancer are consistently worse compared to those who are HIV negative, even when diagnosed at the same stage. However, PLWH are often unaware of their higher risk status and are infrequently referred for cancer prevention or screening by providers, despite these disparities in screening and outcomes. METHODS: To explore reasons why PLWH did not engage in cancer prevention or screening activities, we partnered with urban and rural community clinics with a mixed methods study design, including a quantitative survey and focus groups. RESULTS: In our sample (N=178), 90.4% Black, 57% female, significant differences were found between rural and urban settings related to guideline-concordant uptake of cancer screening and prevention. Only 37% subjects overall reported participating in regular cancer screening. Among women over 50 years who met criteria for breast cancer screening, 100% of women in the rural setting were screened while 55% of eligible women in the urban community received breast cancer screening (p=0.009). Participants from both settings demonstrated gaps in knowledge of their own cancer risk or need to pursue screening. Urban participants were more likely than rural to strongly disagree wtih the statement that HIV+ individuals are at higher risk for cancer (p&lt;0.001). Qualitative data indicated the main reason why PLWH did not participate in prevention or screening activities was because participants were seldom referred for screening by their HIV clinic provider or informed of their risk status. Other qualitative data themes were shock and surprise at learning of their increased risk, or how certain behaviors might reduce cancer risk. DISCUSSION: Upon reviewing results with community partners, the suggestion was made that an HIV Survivorship Care Plan, similar to a Cancer Survivor Care Plan, be developed that could be part of the medical record. The HIV Survivorship Care Plan would incorporate cancer and other chronic disease screening, prevention interventions, and surveillance that would be important for aging PLWH to ensure both patients and providers adhered to evidence-based practices. CONCLUSIONS: PLWH are at increased risk for cancer incidence and mortality as they age, yet are often overlooked as a high-risk population that could greatly benefit from prevention and screening.The application of an HIV Survivorship Care Plan intervention is a novel approach to reduce disparities and improve quality of care and outcomes for PLWH. The tool will be tested and evaluated through additional community-engaged partnerships targeting PLWH.
Citation Format: Theresa W. Gillespie, Loree Mincey, Yuan Liu, Denise Ballard, Kimberly W. Scott, Robert Knott, Minh Ly T. Nguyen, Saurabh Chawla, Joseph Lipscomb, Jessica H. Wells. Survivorship care plan for cancer prevention and screening for people living with HIV (PLWH) [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-024.