This five-year project has several objectives:

1. To learn more about how HIV-positive men who have sex with men understand HPV and anal cancer and their willingness to be vaccinated for HPV or screened for anal cancer
   
   
2. To develop and evaluate an education brochure specifically for these at-risk men and evaluate its effect on the willingness of HIV-positive men to take part in anal screening
   
   
3. To gather evidence about the best ways to screen for anal cancers and dysplasia. Anoscopy is an effective, but invasive, way to look for cancer and dysplasia. This research aims to determine the best ways to determine who should be referred to anoscopy, and how initial screening tools should be used
   
   
4. To compare the outcomes of removing the dysplasia (using ablative therapies) versus ongoing careful monitoring when an HIV-positive man has been diagnosed with high-grade dysplasia
   
   
5. To further understand how anal HPV infection affects the lining of the anus and susceptibility to HIV infection through anal sex.