Engaging Leaders to Elicit Viewpoints on Anal Cancer Prevention (ELDERS) study
Project Number3U01CA275053-03S1
Former Number5U01CA275053-02
Contact PI/Project LeaderNOWAK, REBECCA G. Other PIs
Awardee OrganizationUNIVERSITY OF MARYLAND BALTIMORE
Description
Abstract Text
PROJECT ABSTRACT
Older sexual and gender minorities (SGM) living with HIV have a 100-fold higher risk for anal cancer and are
more likely to be diagnosed with advanced stages of anal cancer with less favorable prognoses, highlighting the
importance of engaging older SGM in anal cancer prevention programs. In Nigeria, men 45 years of age or older
have some of the highest prevalences of HIV, yet they are the most difficult age demographic to recruit into our
anal cancer prevention study, the Integrated Model for the Prevention of Anal Cancer using screen and Treat for
HSIL (IMPACT) study. Only 15% (22/146) of SGM ≥40 years of age who provided their contact information
engaged with our anal cancer prevention program since its launch 8 months ago. The IMPACT research team
noted privacy concerns, socioeconomic class barriers, reluctance to engage with younger SGM at the clinic, and
varying levels of health knowledge as factors contributing to low enrollment of older SGM in anal cancer
screening. To ensure the success of our anal cancer prevention program, participation of older SGM—as the
highest risk group that is likely to benefit the most—is crucial. To better understand how to promote anal cancer
prevention among older SGM, we propose the Engaging LeaDERS (ELDERS) study to elicit the viewpoints and
preferences that older Nigerian SGM living with HIV use when deciding to engage in cancer screening. We
hypothesize that tailoring anal cancer prevention strategies to address culturally relevant barriers and
preferences of older SGM will enhance health-seeking behavior and promote sustainability of anal cancer
prevention programs among this high-risk population in Nigeria. We will use implementation research strategies
to evaluate barriers and enablers to engaging with anal cancer prevention among older SGM. We will also identify
preferences that contribute to the decision-making process among older SGM with respect to accessing anal
cancer prevention. Our study aims will include qualitative and quantitative assessments that embrace community
feedback and our strong partnerships with the SGM community in Nigeria. The information gained from ELDERS
will be applied to improve the recruitment of older SGM within IMPACT as well as the development of a future
Discrete Choice Experiment to improve and sustain anal cancer prevention efforts among older SGM in Nigeria
more broadly.
Public Health Relevance Statement
PROJECT NARRATIVE
Our ELDERS supplement will expand our capacity to support recruitment and sustainability of anal cancer
prevention among older SGM living with HIV in Nigeria. Recognizing the potential challenges to investments in
infrastructure and training, and the need to maintain cost-effectiveness in resource-constrained settings, it is
essential to work with the community to learn how to effectively recruit this highest risk yet hardest-to-reach
group to improve engagement in anal cancer screening and improve outcomes. Ultimately, a better
understanding of the context and perspectives of this community will advance the implementation of innovative
cancer prevention strategies.
NIH Spending Category
No NIH Spending Category available.
Project Terms
AccelerationAddressAffectAfricaAgeAge YearsClinicCommunitiesComplementComprehensionConsolidated Framework for Implementation ResearchDataDecision MakingDetectionDevelopmentDiagnosisEnrollmentEnsureFeedbackFutureGenetic TranscriptionGoalsGuidelinesHIVHealth ServicesHealth StatusHigh PrevalenceInterviewInvestmentsLanguageLearningLesionLocationMalignant neoplasm of anusMethodsModelingNigeriaNigerianOutcomes ResearchPrevalencePreventionPrevention programPrevention strategyPrivacyProcessPrognosisProviderPublished CommentQuestionnairesRandomized, Controlled TrialsResearchResource-limited settingRiskScreening for cancerSexual and Gender MinoritiesStructureTimeTraining and InfrastructureWorkcancer preventioncohortcost effectivenessexperienceexperimental studygender minority communityhealth knowledgehealth seeking behaviorhigh riskhigh risk populationhuman old age (65+)implementation barriersimplementation researchimprovedimproved outcomeinnovationinterestintraepithelialmalemenmortalitypreferencerecruitscreeningscreening programsocioeconomicsstudy populationsuccess
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