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Background: Human papillomavirus (HPV)-associated cancers are a global concern, particularly for sexual minority men (SMM). Understanding awareness and the determinants of these beliefs is crucial for developing educational programs to reduce HPV-associated cancers. This study explored awareness and determinants of beliefs about HPV's carcinogenicity among SMM living with and without HIV in Nigeria. Methods: Participants were recruited through secure social media platforms in Abuja, Nigeria. REDCap surveys captured demographics, sexual practices and participants' beliefs regarding HPV's role in cancer. Multivariable logistic regression modeling was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the relationships between individual characteristics and belief levels stratified by those living with and without HIV. Results: Of 982 participants, the median age was 29 years (interquartile range: 26–34); 64.1% were living with HIV, and 9.7% believed HPV causes cancer. Awareness was highest for anal (82.1%) and penile cancers (15.8%) and less so for oropharyngeal and female HPV-associated cancers (range: 3–7%). Anogenital warts increased the odds of awareness for SMM living with HIV (aOR: 6.4, CI: 3.0–13.6) and for individuals without HIV (aOR: 4.8, CI: 1.6–14.2). Living with HIV for over 6 years was independently associated with a two-fold increased knowledge about HPV's carcinogenicity (aOR: 2.1, CI: 1.1–4.1). Conclusions: Awareness of HPV's carcinogenicity was low; however, those who were aware were more likely to identify male HPV-associated cancers relevant to their own cancer risk. Formalizing targeted education in HIV care settings may promote knowledge and advocacy for prevention strategies. HPV-associated cancers are likely to rise as survival with HIV increases. Knowing the community levels of understanding of personal risk would help tailor educational strategies to promote prevention-seeking behavior. Our study suggests a low understanding of HPV's carcinogenicity, but those aware of its carcinogenicity are more likely to identify male-associated cancers, suggesting that HIV care centers have an opportunity to expand education on cancer risk among their aging population. [ABSTRACT FROM AUTHOR]

Background: Anal cancer rates are rising among sexual and gender minorities (SGM) who live with HIV and engage in anal sex. Given that secondary cancer prevention programs for nonanal cancers are underutilized in sub-Saharan Africa, our objective was to assess concerns for anal cancer and hesitancy with cancer prevention among at-risk Nigerian SGM. Methods: Within 4 weeks, SGM living with HIV were surveyed on levels of worry and hesitancy in engaging with a future anal cancer screening and treatment study. Worry was measured on a 5-point Likert scale (0%, 25%, 50%, 75%, 100%) and categorized as low ≤25%, moderate 50%, and high ≥75%. Ordinal logistic regression identified factors associated with worry by estimating unadjusted and adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Results: Of 800 enrolled SGM, median age was 32 (interquartile range: 25–38) years, 99.2% were on antiretroviral therapy, of which 78.5% reported ≥95% pill adherence. The prevalence of moderate and high worry was 46.9% and 39.5%, respectively. Increasing worry was associated with reporting as a bottom for sexual position (aOR: 3.12; 95% CI: 2.04 to 4.80), top or bottom for sexual position (aOR: 2.94; 95% CI: 1.92 to 4.52), or knowing anyone with anal cancer (aOR: 2.99; 95% CI: 1.36 to 6.57). Participants aged ≥35 years were less worried (aOR: 0.72; 95% CI: 0.59 to 0.95). Ninety-nine percent of participants provided contact information for a future cancer prevention study. Discussion: SGM who heard about and engaged in at-risk practices for anal cancer were willing to access secondary prevention. Addressing biopsychosocial factors such as age could foster future engagement. [ABSTRACT FROM AUTHOR]