Table 1.
Characteristics of individuals conducting lay anal examinations and concordance with clinician examinations in Chicago, Illinois and Houston, Texas, USA 2020–2022.
| Enrolled | Concordance (95% CI) | |
|---|---|---|
| Overall | 714/714 (100.0%) | 0.73 (0.70–0.76) |
| Age, years | 40 (32–54) | |
| Age, years | ||
| 25–34 | 252/714 (35.3%) | 0.79 (0.74–0.84) |
| 35–44 | 161/714 (22.6%) | 0.71 (0.64–0.78) |
| 45–54 | 145/714 (20.3%) | 0.72 (0.65–0.80) |
| 55–81 | 156/714 (21.9%) | 0.67 (0.59–0.74) |
| Waist circumference, cm | ||
| ≤102 | 473/708 (66.8%) | 0.75 (0.72–0.79) |
| >102 | 235/708 (33.2%) | 0.68 (0.62–0.74) |
| Sex at birth | ||
| Male | 703/714 (98.5%) | 0.73 (0.70–0.77) |
| Female | 11/714 (1.5%) | 0.64 (0.35–0.92) |
| Gender identity | ||
| Man | 671/713 (94.1%) | 0.72 (0.69–0.76) |
| Non-binary | 18/713 (2.5%) | 0.89 (0.74–1.00) |
| Transgender woman | 11/713 (1.5%) | 0.82 (0.59–1.00) |
| Transgender man | 9/713 (1.3%) | 0.78 (0.51–1.00) |
| Woman or other | 4/713 (0.6%) | 0.75 (0.33–1.00) |
| Race/ethnicity | ||
| White, non-Hispanic | 334/710 (47.0%) | 0.72 (0.67–0.76) |
| Black, non-Hispanic | 166/710 (23.4%) | 0.80 (0.73–0.86) |
| Hispanic | 163/710 (23.0%) | 0.69 (0.62–0.76) |
| Asian, non-Hispanic | 32/710 (4.5%) | 0.81 (0.68–0.95) |
| Other, non-Hispanica | 15/710 (2.1%) | 0.67 (0.43–0.91) |
| Sexual orientation | ||
| Gay | 601/713 (84.3%) | 0.71 (0.68–0.75) |
| Bisexual | 67/713 (9.4%) | 0.82 (0.73–0.91) |
| Queer | 35/713 (4.9%) | 0.80 (0.67–0.93) |
| Heterosexual, lesbian, I don’t know or other | 10/713 (1.4%) | 0.90 (0.71–1.00) |
| HIV status, self-report | ||
| Negative | 444/703 (63.2%) | 0.75 (0.71–0.79) |
| Positive | 259/703 (36.8%) | 0.70 (0.64–0.75) |
| Dexterity-related medical conditionb | ||
| No | 465/692 (67.2%) | 0.75 (0.71–0.79) |
| Yes | 227/692 (32.8%) | 0.68 (0.62–0.74) |
| Lay anal examination type | ||
| Anal self-examination | 658/714 (92.2%) | 0.73 (0.70–0.76) |
| Anal companion examination | 56/714 (7.8%) | 0.73 (0.62–0.85) |
| Trainer type | ||
| Clinician | 86/714 (12.0%) | 0.85 (0.77–0.92) |
| Non-clinician | 628/714 (88.0%) | 0.72 (0.68–0.75) |
| Clinician type | ||
| Medical doctor | 301/714 (42.2%) | 0.78 (0.74–0.83) |
| Advanced practice provider | 413/714 (57.8%) | 0.69 (0.65–0.74) |
| City | ||
| Chicago | 370/714 (51.8%) | 0.76 (0.72–0.80) |
| Houston | 344/714 (48.2%) | 0.70 (0.65–0.75) |
| Recruitment source | ||
| Social media | 304/711 (42.8%) | 0.75 (0.70–0.80) |
| Clinics | 169/711 (23.8%) | 0.70 (0.62–0.76) |
| Friends | 128/711 (18.0%) | 0.73 (0.66–0.81) |
| Flyers/advertisement | 99/711 (13.9%) | 0.74 (0.65–0.82) |
| Other | 11/711 (1.6%) | 0.82 (0.59–1.00) |
| Lay anal examination results | ||
| True negative | 376/714 (52.7%) | n/a |
| True positive | 146/714 (20.5%) | n/a |
| False negative | 99/714 (13.9%) | n/a |
| False positive | 93/714 (13.0%) | n/a |
| Preferred anal sex position | ||
| Insertive | 163/693 (23.5%) | 0.73 (0.66–0.80) |
| Versatile | 281/693 (40.6%) | 0.74 (0.69–0.79) |
| Receptive | 245/693 (35.4%) | 0.71 (0.65–0.76) |
| Never had anal sex | 4/693 (0.6%) | 1.00 n/a |
| Difficulty with ASE/ACE | ||
| Easy or very easy | 640/708 (90.4%) | 0.74 (0.71–0.77) |
| Hard or very hard | 68/708 (9.6%) | 0.62 (0.50–0.73) |
| Pain with ASE/ACE | ||
| None | 681/710 (95.9%) | 0.73 (0.69–0.76) |
| A little | 23/710 (3.2%) | 0.78 (0.61–0.95) |
| A lot | 2/710 (0.3%) | 1.00 n/a |
| I don’t know | 4/710 (0.6%) | 1.00 n/a |
| Ever checked anus for disease | ||
| No or I don’t know | 385/713 (54.0%) | 0.71 (0.67–0.76) |
| Yes | 328/713 (46.0%) | 0.75 (0.70–0.80) |
| Worry about getting anal cancer | ||
| None | 421/710 (59.3%) | 0.74 (0.70–0.78) |
| A little | 204/710 (28.7%) | 0.70 (0.64–0.76) |
| Some | 68/710 (9.6%) | 0.82 (0.73–0.91) |
| Quite a lot | 17/710 (2.4%) | 0.47 (0.23–0.71) |
| Plans to do ASE/ACE in the future | ||
| Strongly agree | 508/709 (71.7%) | 0.74 (0.70–0.78) |
| Agree | 184/709 (26.0%) | 0.70 (0.63–0.77) |
| Disagree | 3/709 (0.4%) | 1.00 n/a |
| Strongly disagree | 2/709 (0.3%) | 0.00 n/a |
| I don’t know | 12/709 (1.7%) | 0.77 (0.54–1.00) |
| Would see a doctor for a persistent anal problem | ||
| Strongly agree | 481/711 (67.7%) | 0.74 (0.69–0.77) |
| Agree | 183/711 (25.7%) | 0.75 (0.69–0.82) |
| Disagree | 12/711 (1.7%) | 0.67 (0.40–0.93) |
| Strongly disagree | 3/711 (0.4%) | 0.33 (0.00–0.87) |
| I don’t know | 32/711 (4.5%) | 0.59 (0.42–0.76) |
| Preference for ASE/ACE or doctor-provided exam | ||
| ASE or ACE | 244/705 (34.6%) | 0.75 (0.70–0.80) |
| Doctor-provided exam | 461/705 (65.4%) | 0.72 (0.68–0.76) |
| COVID-19 pandemic-associated enrolment datec | ||
| Prior to trial suspension | 20/714 (2.8%) | 0.70 (0.46–0.88) |
| After trial resumed | 694/714 (97.2%) | 0.73 (0.70–0.77) |
Note. Data are n (%) or median (interquartile range).
ASE/ACE, anal self-examination, or anal companion examination; n/a, not applicable.
Other includes Native American or Alaskan Native, Hawaiian or Pacific Islander, other, and I don’t know.
Conditions were arthritis, carpal tunnel syndrome, cerebral palsy, diabetes, fibromyalgia, chronic lower back pain, motor neuron diseases, multiple sclerosis, obesity, spina bifida, spinal cord injury, stroke, and other (neuropathy, lower back nerve compression, tremors in hand, McArdle disease, autism, scoliosis, knee pain, scapular dyskinesis, transverse myelitis, osteoporosis, thoracic outlet syndrome, cervicalgia, causalgia and herniated disc).
Study enrollment was suspended due to COVID-19 pandemic stay-at-home orders on March 14, 2020, and then resumed on July 30, 2020, in Chicago and October 1, 2020, in Houston.