Emotional support networks and discussion of anal cancer among sexual minority men in Nigeria: insights from an ego-centric analysis

BACKGROUND: This study examined the role of emotional support networks in shaping health-related communication among sexual minority men (SMM) living with HIV in Nigeria, a context where criminalization and stigma limit social integration and access to care. We conducted a cross-sectional survey of 250 SMM receiving HIV care at an SMM-affirming clinic in Abuja. METHODS: Participants completed a structured questionnaire assessing demographics, HIV-related characteristics, HPV knowledge, anal cancer awareness, and emotional support network composition. Emotional support network attributes were compared by duration of HIV diagnosis (≤ 5 years vs. >5 years), and logistic regression models assessed factors associated with discussing anal cancer within support networks. RESULTS: Participants living with HIV for > 5 years had larger emotional support networks and were more likely to report discussing same-sex relationship issues and anal cancer with alters. Discussing same-sex relationships and receiving medical care support from alters were strongly associated with increased likelihood of discussing anal cancer. Network density (e.g., how well alters know one another) did not differ by duration of HIV diagnosis. CONCLUSION: These findings highlight the influence of interpersonal trust and relationship context on communication about stigmatized health topics. Leveraging emotional support networks, particularly for individuals newly diagnosed with HIV, may strengthen engagement in preventive cancer care and improve health outcomes for SMM in hostile sociopolitical environments.