Abstract
Objective: Prostate cancer is the most common invasive cancer in gay and bisexual men. Despite the unique sexual and urinary concerns of this group, nearly all studies of prostate cancer rehabilitation post-treatment have focused on heterosexual men. Older gay and bisexual men, the generation most likely to experience prostate cancer, also have high prevalence of human immunodeficiency virus (HIV), which is associated with lower quality of life. Research has indicated that people with HIV may experience health disparities in cancer treatment, but to our knowledge, this is the first quantitative study of the association between HIV status and health-related quality of life (HRQOL) in gay and bisexual men with prostate cancer.
Methods: Data from the Restore study, a cross-sectional online survey of gay and bisexual men treated for prostate cancer and residing in the United States or Canada, were used to examine this association. The Expanded Prostate Cancer Index Composite (EPIC) was used to assess function and bother in four domains: urinary, sexual, bowel, and hormone. Overall physical and mental HRQOL was assessed utilizing the SF-12 Health Survey. Multivariate analysis of variance (MANOVA) was used to evaluate the association between HIV status and HRQOL scores. Models were adjusted for age, race, treatment (prostatectomy, radiation, or advanced treatment), relationship status (partnered/married versus single/dating/widowed/divorced), preferred role in sex, and number of comorbidities.
Results: Of 193 participants, 24 (12.4%) reported an HIV diagnosis, including 3 diagnosed after their prostate cancer treatment. The cohort was 89 percent white, with mean age 63.4 years. After adjustment for demographic and treatment characteristics, HIV-positive status was associated with lower scores on the EPIC urinary (RD: -10.8, 95% CI: -19.5 to -2.2) and sexual (RD: -10.3, 95% CI: -20.2 to -0.4) domains. Although there were no statistically significant associations found in the other domains, HIV-positive participants reported lower outcomes in all domains except the SF-12 mental domain (RD: 0.3, 95% CI: -5.0 to 5.6).
Conclusion: Our findings, though imprecise, provide evidence that HIV status may be associated with poorer HRQOL in gay and bisexual prostate cancer survivors.
Citation Format: Elizabeth J. Polter, Christopher W. Wheldon, Nidhi Kohli, B. R. S. Rosser. The role of HIV status in health-related quality of life in gay and bisexual prostate cancer survivors: Findings from the Restore study [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B037.
