HPV awareness and anal cancer prevention among sexual minority men living with HIV in Nigeria: insights from an affirming clinical setting.

BACKGROUND

Sexual minority men (SMM) living with HIV face an elevated risk of anal cancer, and SMM-affirming HIV clinics serve as vital entry points for cancer prevention. We evaluated human papillomavirus (HPV) knowledge, vaccine acceptability and whether time living with HIV was associated with anal cancer symptom awareness.

METHODS

A cross-sectional survey was conducted at an HIV clinic offering anal cancer prevention in Abuja, Nigeria. Descriptive statistics were used to summarize HPV knowledge and vaccine acceptability. Multivariable negative binomial regression evaluated the number of anal cancer symptoms correctly reported using adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs).

RESULTS

Among 249 SMM living with HIV, 20.5% reported having heard of HPV. Fewer than 20% correctly identified key anal cancer symptoms, including anal bleeding (15.7%) and a lump or mass in the anus (16.9%). Time living with HIV was initially associated with anal cancer symptom awareness, but not after adjustment (aPR 1.02, 95% CI 0.98-1.07). Other independent predictors of anal cancer symptom awareness were anal cancer screening (aPR 1.51, 95% CI 1.15-1.97) and knowing HPV vaccine can prevent anal cancer (aPR 1.52, 95% CI 1.18-1.98). Despite low HPV awareness, 93.6% of participants reported willingness to receive HPV vaccine.

CONCLUSION

Integrating cancer prevention services into SMM-affirming HIV care may offer an opportunity to strengthen HPV-related knowledge and reduce cancer disparities.