HPV-associated anal cancer is one of the most prevalent non-AIDS defining cancers affecting gay men living with HIV. Drawing on interviews with 25 HIV-positive gay men living in Toronto in 2017, we explored their responses to anal cancer as a comorbidity risk and the necessity of preventative screening. These participants had previously been screened for anal cancer through a clinical trial. The majority of our sample did not initially consider anal cancer a health priority. They relied on narratives of living with HIV – that is, on their HIV biographies – to make sense of anal cancer’s significance given their self-described lack of knowledge. This included references to personal-level narratives of the biographical disruption and revision associated with a HIV diagnosis, as well as reflections on community-level and socio-historical trends in the HIV epidemic. Drawing on these narratives, some started to accept anal cancer as a significant comorbidity risk, while others remained ambivalent. Those who began to accept anal cancer as significant integrated it into their HIV biographies to present anal cancer as a threat to the ontological security they have gained managing HIV in an era of effective treatment and to position themselves as pragmatic, responsible health-seekers. Others drew on their HIV biographies to vocalise resistance to chronic risk and medicalisation. Our analysis points to the fundamental role narratives play on everyday risk perception practices, health decision-making and, for those managing a chronic illness, on securing ontological security and presenting a coherent self-identity under conditions of expanding risks and prevention possibilities.

HPV相关的肛门癌是影响艾滋病病毒携带者的最普遍的非艾滋病定义癌症之一。根据2017年对25位居住在多伦多的HIV阳性男同性恋者的采访，我们探讨了他们对肛门癌的反应，这是合并症的风险和预防性筛查的必要性。这些参与者先前已通过临床试验筛查了肛门癌。我们的大多数样本最初并未将肛门癌视为健康优先事项。由于他们自称缺乏知识，他们依靠艾滋病病毒的叙述（即艾滋病病毒的传记）来理解肛门癌的重要性。其中包括对个人层面的叙述，这些叙述涉及与HIV诊断相关的个人传记破坏和修订，以及对艾滋病毒流行的社区层面和社会历史趋势的反思。利用这些叙述，一些人开始接受肛门癌作为重大的合并症风险，而另一些人则持矛盾态度。那些开始高度重视肛门癌的人将其纳入自己的HIV传记中，以表示肛门癌对他们在有效治疗时代已获得管理HIV的本体论安全性的威胁，并将自己定位为务实，负责任的健康寻求者。其他人则利用自己的HIV传记来表达对慢性病和医疗的抵抗力。我们的分析指出，叙事在日常风险感知实践，健康决策中起着根本作用，对于那些慢性病患者，