Anal cancer is a type of cancer that can happen if a virus called high-risk human papillomavirus (hrHPV) stays in the body for a long time. Before anal cancer appears, there's usually a warning sign called anal high-grade squamous intraepithelial lesion (aHSIL). This study wants to find better ways to check for aHSIL, especially in high-risk groups such as Black or Latinx people, men who have sex with men (MSM), and women with certain high-grade conditions. The study will also look at things like DNA changes and how our immune system reacts.

Participants will need to fill out forms and give samples, like blood. These samples will be used for research now and in the future. The study is for people 30 years and older, who are Black or Latinx, and have certain medical histories. People who had certain treatments recently or are pregnant cannot join the study.

• The study involves filling out questionnaires and providing samples.
• Participants must be 30 or older and meet specific medical criteria.
• Consent can be given in person or remotely.