Do we DARE? Improving digital ano-rectal examination in men who have sex with men living with HIV: a quality improvement initiative
Shannon C. Woodward
A * , Alexandra H. Tyson A B and Sarah J. Martin A B
+ Author Affiliations
- Author Affiliations
A Canberra Sexual Health Centre, PO Box 11, Woden, ACT 2606, Australia.
B Medical School, Australian National University, Acton, ACT 2601, Australia.
Sexual Health 19(3) 230-232 https://doi.org/10.1071/SH21247
Submitted: 20 January 2022 Accepted: 31 May 2022 Published: 16 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing
Abstract
Men who have sex with men (MSM) living with HIV are at increased risk of anal cancer and annual screening via digital ano-rectal examination (DARE) is recommended. Baseline audit (Cycle 1) was undertaken of the medical records of MSM living with HIV aged ≥50 years (n = 85) from 1 January 2017 to 31 December 2018, in line with guidelines at the time. Data collection included whether DARE was discussed and offered, and whether DARE was accepted or declined. We provided staff training and altered clinic proformas aiming to increase DARE. Audit Cycle 2 (Cycle 2) was undertaken of eligible MSM (n = 86) who attended between 1 January 2019 to 31 December 2020. DARE frequency increased from 4.7% in Cycle 1 to 41.8% in Cycle 2 (P < 0.001) and discussion and offer of DARE increased from 8% to 64% in Cycle 2 (P < 0.001).
Keywords: anal cancer, anal examination, anal warts, DARE, digital ano-rectal examination, HIV, MSM, screening.
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