Neukam, KarinMilanés Guisado, YusnelkisFontillón, MaríaMerino, LauraSotomayor, CésarEspinosa, NuriaLópez-Cortés, Luis FViciana, PompeyoSeVIHanal Study Group2023-01-252023-01-252019-02-01http://hdl.handle.net/10668/13507To determine the required learning time for high-resolution anoscopy (HRA)-guided biopsy to detect histological high-risk squamous intraepithelial lesions (hHSIL) and to identify factors that impact on the training process. All HIV-infected, screening-naïve men-who-have-sex-with-men who underwent HRA conducted by one single observer from 2010 to 2017 in a Spanish HIV-outpatient clinic were analysed. Eighty-five (14.7%) of the 581 patients included presented hHSIL. The factors associated with the capacity to detect hHSIL [adjusted odds ratio (aOR), 95% confidence interval (95%CI)] were the presence of cytological HSIL (3.04, 1.78-5.21; p  The data support the growing evidence that the proposed training volume of 50-200 performances is underestimated. Extensive training of both anoscopist and pathologist is warranted and the development of tools to support the diagnostic performance may be considered.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Anal squamous cell carcinomaHigh-resolution anoscopyHuman papillomavirusLearning curveLiquid-based cytologyOperator experienceAdultAnus NeoplasmsBiopsyEndoscopyHIV InfectionsHumansLearning CurveMaleMiddle AgedPreceptorshipProspective StudiesRetrospective StudiesSpainSquamous Intraepithelial LesionsTime Factorsresearch article30716543open access10.1016/j.pvr.2019.01.0032405-8521PMC6374501https://doi.org/10.1016/j.pvr.2019.01.003https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374501/pdf