Understanding HPV vaccine preferences among sexual minority men living with HIV in Abuja, Nigeria using a discrete choice experiment

BACKGROUND: Sexual minority men (SMM) in Nigeria face a disproportionate burden of HPV-related diseases, yet HPV vaccination uptake remains limited due to structural, financial, and sociocultural barriers. Understanding SMM's preferences for vaccination delivery is critical to designing accessible, affirming, and equitable prevention strategies. METHODS: A discrete choice experiment (DCE) was conducted with 250 SMM receiving HIV-related care at an affirming clinic in Abuja, Nigeria. Seven attributes were identified through literature review and stakeholder engagement. Participants completed 12 choice tasks comparing hypothetical HPV vaccination scenarios. Hierarchical Bayes estimation was used to derive individual-level utilities and attribute importance scores. RESULTS: Participants strongly preferred receiving HPV-related services in SMM-affirming settings and at no cost. Setting type (19.4%) and cost (19.2%) were the most influential attributes, followed by wart prevention (11.4%) and information availability (7.8%). Services described as protecting others from HPV-related outcomes, prevent warts, and require moderate travel (60 min) were moderately preferred. Higher levels of vaccine protection and information availability were less influential in decision-making. CONCLUSIONS: Preferences among SMM in Nigeria emphasize the need for free, affirming, and inclusive HPV vaccination services. Addressing structural barriers, especially stigma and cost, will be essential to increasing vaccine uptake. Findings support targeted, community-informed strategies to reduce HPV disparities and promote health equity.