Sex-Specific Landscapes of Crossover and Noncrossover Recombination in Coppery Titi Monkeys (Plecturocebus cupreus).

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide and is causally linked to anal, penile, and oropharyngeal cancers. Gay, bisexual, and other men who have sex with men (GBMSM) experience a disproportionate burden of HPV infection and HPV-related disease because of high anal HPV prevalence, frequent multisite infection, and persistent exposure within sexual networks. In mainland China, HPV vaccination policy and public messaging have historically focused on women and girls, while vaccination opportunities for men have been comparatively limited. During the survey period, a male HPV vaccination pathway was only beginning to emerge: the quadrivalent HPV vaccine was approved for males aged 9–26 y in January 2025, while male-facing services and public messaging remained limited and largely self-paid. As a result, a substantial proportion of Chinese GBMSM remained unvaccinated or uncertain about where men could obtain vaccination during the period in which primary prevention could confer the greatest benefit. Evidence from China suggests multilevel barriers to vaccination among sexual minority men. Structural barriers include high out-of-pocket costs, limited service visibility, uncertainty about where men can be vaccinated, and the lack of a stable male-facing vaccination pathway during the study period. At the individual level, previous studies and meta-analytic evidence have highlighted low HPV awareness, low perceived susceptibility, stigma related to sexual orientation, limited clinician recommendation, and inconsistent linkage between knowledge and action. However, most existing studies have been descriptive or have examined isolated predictors, providing limited insight into how these factors interact to shape vaccine decision-making. The Information-Motivation-Behavioral Skills (IMB) model offers a parsimonious account of health behavior change, positing that accurate information, sufficient motivation, and behavioral skills jointly support action. HPV-related research has increasingly shown that IMB-informed approaches can be relevant to vaccine decision-making, including work among Malaysian men who have sex with men and mainland Chinese college women. Within the model, behavioral skills are commonly represented through perceived capability or self-efficacy, which is central for translating intention into action.