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Strengthening Anal Cancer Prevention In Abuja, Nigeria: Identifying Barriers And Potential Strategies To Improve Training

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Strengthening Anal Cancer Prevention In Abuja, Nigeria: Identifying Barriers And Potential Strategies To Improve Training

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Strengthening anal cancer prevention in Abuja, Nigeria: Identifying barriers and potential strategies to improve

Connor R Volpi¹, John Chama², Megan E Mansfield³

¹Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

PLOS Global Public Health

|July 2, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Training on anal cancer prevention for sexual minority males (SMM) living with HIV in Nigeria requires adapting implementation science frameworks. Addressing barriers like cost and adaptability through local engagement is crucial for effective prevention strategies.

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Area of Science:

Implementation Science
Public Health
Oncology

Background:

Anal cancer incidence is significantly higher (100-fold) in sexual minority males (SMM) living with HIV.
Existing anal cancer prevention training faces resource and practitioner limitations in Africa.
Adapting training using implementation science is vital for resource-limited settings.

Purpose of the Study:

To evaluate the adaptation of anal cancer prevention training using an implementation science framework in a Nigerian SMM-friendly clinic.
To identify barriers and facilitators to training using the Consolidated Framework for Implementation Research (CFIR) and CFIR-Expert Recommendations for Implementing Change (ERIC) tools.
To develop culturally sensitive strategies for enhancing anal cancer prevention training.

Main Methods:

Utilized the CFIR Card Game to assess barriers among internal stakeholders, external stakeholders, and patients.
Employed culturally adapted text and a hybrid format for consensus discussions.
Applied the CFIR-ERIC Matching Tool to identify potential implementation strategies.

Main Results:

Internal stakeholders identified adaptability, cost, and lack of external change agents as barriers.
External stakeholders highlighted adaptability, design quality, and financial burden, suggesting advocacy.
Patients raised concerns about adaptability and external policies, emphasizing local involvement and strategic adaptations.

Conclusions:

Key strategies include identifying champions, altering incentives, and ensuring local adaptations.
Cultural sensitivity and engagement with local stakeholders are paramount for successful training.
Policy enforcement and financial support are essential for enhancing anal cancer prevention training in Nigeria.