Improving Cancer Care for People Living With HIV: A Qualitative Study of Provider Knowledge, Attitudes, and Practice

Henry, Valencia; Stephens, Maya J.; Galyean, Patrick; Young, Jeanette; Zickmund, Susan; Knettel, Brandon A.; Bartlett, John A.; Watt, Melissa H.; Pollak, Kathryn I.; Ubel, Peter A.; Fagerlin, Angela; Suneja, Gita

doi:10.1016/j.ijrobp.2023.01.045

Cited by 3 publications

(2 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several barriers such as lack of training in treating malignancies in PWH, fear of inadvertent HIV disclosure, and challenges with care coordination between different specialties were included. 28 Finally, systematic issues with the delivery of health care in the United States are also present. PWH have reported barriers such as financial burden related to cancer care as a challenge to cancer treatment, 29 in addition to documented disparities in general health care utilization for PWH compared with those without.…”

Section: Discussionmentioning

confidence: 99%

“…Individual-level findings suggest that among those with the dual burden of HIV and cancer, HIV-related stigma, treatment side effects, and behavioral and physical pain concerns are barriers to cancer care and treatment. [26][27][28][29] In addition, qualitative studies of PWH have reported challenges related to coping and behavioral health. 29 Recently, work has also examined barriers to cancer treatment for PWH from the perspective of oncologists.…”

Section: Predictors Of Lack Of Cancer Treatment In Pwhmentioning

confidence: 99%

See 1 more Smart Citation

Cancer Treatment Disparities in People With HIV in the United States, 2001-2019

McGee-Avila,

Suneja,

Engels

et al. 2024

JCO

Self Cite

View full text Add to dashboard Cite

PURPOSE People with HIV (PWH) have worse cancer outcomes, partially because of inequities in cancer treatment. We evaluated cancer treatment disparities among PWH, including an assessment of changes in disparities over time. METHODS We used data from the HIV/AIDS Cancer Match Study, a population-based HIV and cancer registry linkage to examine diffuse large B-cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and cancers of the cervix, lung, anus, prostate, colon, and female breast. Outcomes included receipt of (1) any cancer treatment and (2) standard therapy among patients with local-stage cancer. We assessed associations between HIV and each outcome by estimating adjusted prevalence odds ratios (aORs) with 95% CI and trends over time. We identified predictors of nonreceipt of cancer treatment in PWH. RESULTS From 2001 to 2019, compared with people with cancer without HIV (n = 2,880,955), PWH (n = 16,334) were more likely to not receive cancer treatment for cervical cancer (aOR, 2.03 [95% CI, 1.52 to 2.70]), DLBCL (aOR, 1.53 [95% CI, 1.38 to 1.70]), HL (aOR, 1.39 [95% CI, 1.19 to 1.63]), lung cancer (aOR, 1.79 [95% CI, 1.65 to 1.93]), prostate cancer (aOR, 1.32 [95% CI, 1.21 to 1.44]), colon cancer (aOR, 1.73 [95% CI, 1.43 to 2.08]), and breast cancer (aOR, 1.38 [95% CI, 1.07 to 1.77]). Similar associations were observed in PWH with local-stage cancers although no difference was observed for anal cancers. The association between HIV and nonreceipt of cancer treatment significantly decreased over time for breast, colon, and prostate cancers (all P trend <.0001), but PWH remained less likely to receive treatment in 2014-2019 for DLBCL, cervix, and lung cancers. Among PWH, Black individuals, people who inject drugs, and those 65 years and older were less likely to receive cancer treatment. CONCLUSION Disparities in receipt of cancer treatment persist for PWH in the United States in contemporary time periods. Solutions to address inequitable receipt of cancer treatment among PWH are urgently needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Predictors Of Lack Of Cancer Treatment In Pwhmentioning

confidence: 99%

Cancer Treatment Disparities in People With HIV in the United States, 2001-2019

McGee-Avila,

Suneja,

Engels

et al. 2024

JCO

Self Cite

View full text Add to dashboard Cite

show abstract

Impact of Social Determinants of Health on Cancer Treatment Referrals in Patients Living with HIV in the United States: A Narrative Review.

George,

Mansuri,

Qureshi

et al. 2024

Journal of Cancer Policy

View full text Add to dashboard Cite

Supportive Care for People Living with HIV and Cancer in the United States

Ahmad,

Islam,

Aboulafia

2024

International Journal of Cancer Care and Delivery

View full text Add to dashboard Cite

People with HIV (PWH) in the United States (US) are living longer and are aging into demographic groups in which chronic conditions such as cancer, specifically non-AIDS defining cancers, more commonly occur. Not only do PWH have higher rates of these cancers, but they are also more likely to experience higher, stage-adjusted, cancer-specific mortality compared to their HIV-negative counterparts. One important contributing factor is the disparity in the type of treatment offered to cancer patients with HIV. In a study comparing the use of palliative care among patients with cancer living with and without HIV in the US, researchers found that among those diagnosed with early stage-cancer, PWH had 96% higher odds of receiving palliative care versus those without HIV. On the other hand, among those diagnosed with stage 4 cancer, PWH had 30% lower odds of receiving palliative care compared to their HIV-negative counterparts. The investigators also showed that PWH who did not receive palliative care had 48% lower odds of receiving curative treatment. As for those who did receive palliative care, they were also less likely to receive curative treatment compared to those without HIV, suggesting that PWH were receiving palliative care in lieu of curative treatment. These findings reinforce prior data that curative treatment is not routinely offered to PWH in an equitable way and underscore the importance of developing efforts to improve outcomes in this marginalized population.

show abstract

Improving Cancer Care for People Living With HIV: A Qualitative Study of Provider Knowledge, Attitudes, and Practice

Cited by 3 publications

References 29 publications

Cancer Treatment Disparities in People With HIV in the United States, 2001-2019

Cancer Treatment Disparities in People With HIV in the United States, 2001-2019

Impact of Social Determinants of Health on Cancer Treatment Referrals in Patients Living with HIV in the United States: A Narrative Review.

Supportive Care for People Living with HIV and Cancer in the United States

Contact Info

Product

Resources

About