Cancer represents a significant source of morbidity and mortality among people living with HIV/AIDS (PLWHA) in the United States, accounting for 20–30% of deaths in this population (Engels et al., 2017; Morlat et al., 2014; Goehringer et al., 2017). As PLWHA age and cancer-related burden continues to shift from predominantly due to AIDS-defining cancers to non-AIDS-defining cancers, prostate cancer is projected to account for the greatest proportion of cancer burden in men living with HIV in the United States through 2030, however, incidence of prostate cancer has been reported to be lower in men living with HIV compared to men without HIV (Shiels et al., 2018; Robbins et al., 2015; Marcus et al., 2014; Shiels et al., 2010; Leapman et al., 2022; Coghill et al., 2018). It is possible that this difference is attributable to differences in screening.

It has been reported that men living with HIV received more PSA testing than men without HIV among privately-insured men in California over 2000–2007 (Marcus et al., 2014). Conversely, mostly low-income men with AIDS receiving care in an urban clinic in the United States reported receiving PSA testing less than rates observed in the United States general population in 2000–2008 (Shiels et al., 2010) and men living with HIV enrolled in the United States-based Veterans Aging Cohort Study received PSA testing at lower rates than matched controls without HIV in 2000–2015 (Leapman et al., 2022). Characteristics of men living with HIV, such as race, access to and engagement in healthcare, insurance coverage, and HIV risk group may influence receipt of PSA test. Additional factors, which may vary by HIV status, including individuals' healthcare priorities, healthcare providers' priorities, and healthcare setting, may also influence screening. Factors related to HIV, such as control of HIV, life expectancy, and comorbid conditions, could also affect the decision to screen.

PSA testing requires only a blood draw and is inexpensive compared to most other cancer screening modalities, suggesting fewer barriers to screening. However, given uncertain benefits and potential harms of overdiagnosis, deciding to screen is not always clear. It is not known what factors influence receipt of PSA testing among men living with HIV and whether PSA testing may vary by subgroup of men living with HIV. The objective of this study is to describe trends in and identify correlates of receipt of PSA testing in a cohort of men living with HIV followed from 2000 through 2020.