‘Does human papillomavirus (HPV) cause cancer?’ – A cross-sectional study of HPV awareness among sexual minority men in Nigeria
Connor R. Volpi
A , John Chama B , Natalia Blanco C , Ruxton Adebiyi B , Kareshma Mohanty D , Ayuba Doroh B , Jumoke A. Aigoro B , Christiana Katu B , Uche Ononaku B , John Maigida B , Abayomi Aka E , Ashley Shutt C , Patrick Dakum B , Man Charurat C , Sylvia Adebajo B C and Rebecca G. Nowak C *
A
B
C
D
E
Abstract
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.
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.
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).
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.
Keywords: cancer, health literacy, HIV, HPV vaccine, human papillomavirus, lower- and middle-income countries, MSM, SSA.
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