Evaluating the Impact of Intersectional Stigma on Linkage to Cancer Care in HIV-Associated Kaposi's Sarcoma in East Africa

评估东非艾滋病毒相关卡波西肉瘤中交叉耻辱与癌症护理的影响

基本信息

项目摘要

This application is being submitted in response to the Notice of Special Interest (NOSI) identified as "NOT- CA-21-026”. In sub-Saharan Africa, Kaposi’s sarcoma (KS) remains one of the most common HIV-related cancers and — by virtue of the high prevalence of HIV infection in the region — one of the commonest in the general population. Not only is KS common in Africa, but it is also frequently fatal; two-year mortality following KS diagnosis is as high as 45%. Reasons for poor survival are diverse, but one potentially modifiable cause is failure to promptly link patients to cancer care following diagnosis. In one setting in Kenya, for example, only 50% of patients with KS clinically eligible for chemotherapy actually received it. Stigma occurs when individuals are recognized, labeled as “other”, and discriminated against because of socially undesirable characteristics. In resource-rich settings, the health consequences of stigma, including amongst persons with cancer, have been recognized for over 50 years. In resource-limited settings, stigma has been most intensely studied amongst persons with HIV infection. There has been comparatively scant investigation of stigma amongst patients with cancer in resource-limited settings, but where it has been studied, manifestations are similar to resource-rich settings. HIV-associated KS in Africa has the potential to confer three co-occurring forms of stigma: cancer-related stigma, skin disease-related stigma, and HIV-related stigma. As such, this cancer provides a unique lens to study stigma in resource-limited settings. If present amongst patients with HIV-associated KS, these three “intersecting” forms of stigma may impact healthcare engagement at many levels, including the crucial initial linkage to cancer care after diagnosis. As an administrative supplement to U54 CA254571, our overarching goal is to study the magnitude and impact of stigma on linkage to care in patients with HIV-associated KS in East Africa. Our specific aims are: Aim 1. Describe intersectional stigma in patients with newly diagnosed HIV-associated KS. Using semi-structured interviews and quantitative instruments, we will describe the prevalence and relationship between 3 forms of stigma: a) cancer-related, b) skin disease-related; and c) HIV-related. Aim 2. Assess the impact of stigma on linkage to cancer care in HIV-associated KS. Among patients with newly-diagnosed HIV-associated KS in western Kenya, we will evaluate the impact of the 3 stigma types on linkage to cancer care, defined as time to a) first Oncology Clinic visit, b) first evaluation by an oncology provider at the clinic qualified to make a treatment plan, and c) initial chemotherapy use. To address these aims, we will study stigma in an already-existing population laboratory for the investigation of HIV-associated KS in the AMPATH network in western Kenya, supported by parent grant U54 CA254571. Findings from this work are expected to expand our understanding of stigma and its impact on linkage to care in patients with KS and inform future stigma reduction interventions for all cancers in sub-Saharan Africa.
本申请是根据特别利益通知(NOSI)提交的,该通知被标识为“NOT-”

项目成果

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Andrew Ddungu Kambugu其他文献

Andrew Ddungu Kambugu的其他文献

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{{ truncateString('Andrew Ddungu Kambugu', 18)}}的其他基金

Developmental Core
发展核心
  • 批准号:
    10669172
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
A Mentored Research Experience in Investigating the Socio-geographic Expansion to Liberia of a Novel Campaign-based Public Health Approach to Cervical Cancer Prevention
调查基于运动的新型宫颈癌预防公共卫生方法向利比里亚的社会地理扩张的指导研究经验
  • 批准号:
    10846445
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
Developmental Core
发展核心
  • 批准号:
    10454922
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
United States-East Africa HIV-Associated Malignancy Research Center (USEAHAMRC) for Career Development and the Prevention, Early Detection and Efficient Linkage to Care for Virus-related Cancers
美国-东非艾滋病毒相关恶性肿瘤研究中心 (USEAHAMRC),致力于职业发展以及病毒相关癌症的预防、早期检测和有效护理联系
  • 批准号:
    10669166
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
Developing measurements to evaluate intersectional stigma related to cancer and HIV
开发测量方法来评估与癌症和艾滋病毒相关的交叉耻辱
  • 批准号:
    10844755
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
United States-East Africa HIV-Associated Malignancy Research Center (USEAHAMRC) for Career Development and the Prevention, Early Detection and Efficient Linkage to Care for Virus-related Cancers
美国-东非艾滋病毒相关恶性肿瘤研究中心 (USEAHAMRC),致力于职业发展以及病毒相关癌症的预防、早期检测和有效护理联系
  • 批准号:
    10454919
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
United States-East Africa HIV-Associated Malignancy Research Center (USEAHAMRC) for Career Development and the Prevention, Early Detection and Efficient Linkage to Care for Virus-related Cancers
美国-东非艾滋病毒相关恶性肿瘤研究中心 (USEAHAMRC),致力于职业发展以及病毒相关癌症的预防、早期检测和有效护理联系
  • 批准号:
    10084687
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
United States-East Africa HIV-Associated Malignancy Research Center (USEAHAMRC) for Career Development and the Prevention, Early Detection and Efficient Linkage to Care for Virus-related Cancers
美国-东非艾滋病毒相关恶性肿瘤研究中心 (USEAHAMRC),致力于职业发展以及病毒相关癌症的预防、早期检测和有效护理联系
  • 批准号:
    10215455
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
Developmental Core
发展核心
  • 批准号:
    10215458
  • 财政年份:
    2020
  • 资助金额:
    $ 19.81万
  • 项目类别:
ACUTE FEBRILE ILLNESS IN UGANDA
乌干达的急性发热性疾病
  • 批准号:
    10665662
  • 财政年份:
    2019
  • 资助金额:
    $ 19.81万
  • 项目类别:

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