Understanding Stigma as a barrier to cancer prevention and treatment in Uganda and Zambia

了解耻辱是乌干达和赞比亚癌症预防和治疗的障碍

• 批准号: 10845119
• 负责人: Fastone Goma
• 金额: $ 19.04万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10845119
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Adherence; Administrative Supplement; Africa; African; Alcohol abuse; Behavior; Cancer Center; Cancer Control; Caring; Communities; Country; Data; Development; Diagnosis; Dimensions; Disease; Education; Focus Groups; Fright; Goals; HIV; Health; Health Personnel; Health Services; Health Services Accessibility; Health Status; Health behavior; Individual; Intervention; Knowledge; Life; Malignant Neoplasms; Measures; Mental Health; Parents; Participant; Patients; Persons; Policy Maker; Population; Population Growth; Prevalence; Preventive; Preventive service; Preventive treatment; Public Health; Public Health Schools; Punishment; Research; Risk Behaviors; Screening for cancer; Services; Shame; Stereotyping; Surveys; Testing; Tobacco; Tobacco Use Cessation; Tobacco use; Uganda; Universities; Virus Diseases; Zambia; aging population; cancer diagnosis; cancer prevention; cancer risk; cancer therapy; care systems; curative treatments; high risk; improved; insight; interest; low and middle-income countries; medical schools; mortality; parent project; prevent; prevention service; response; screening; screening program; screening services; social stigma; study population; tobacco control; treatment services

Project Summary/Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA- 23-025” Administrative Supplement to Support Global Cancer Stigma Research. Cancer kills more than a half a million Africans each year with rates expected to rise over the next decade due to factors such as population growth and aging, delayed diagnosis resulting from limited knowledge of cancer, lack of biomedical treatment, and stigma. Traditionally, the majority of cancers diagnosed throughout Africa have been types associated with viral infection, particularly ‘AIDS-defining malignancies’ which place people living with HIV (PLWH) at a substantially higher risk of being diagnosed with cancer and dying of cancer compared to those who are not living with HIV. Health behaviors that increase cancer risk, such as tobacco use, are also more prevalent among PLWH and can further increase mortality from several Non-Aids defining Cancers (NADCs). Extensive research has been carried out on the impact of HIV stigma as a barrier to HIV prevention, testing, and care. Formative research carried out in our Parent Project also revealed that patient’s feared utilization of HIV- related health centers for cancer prevention and screening services, including tobacco use cessation interventions, would reveal their HIV status. Far less research has focused on cancer stigma within PLWH communities. Cancer stigma may originate from cultural stereotypes that cancer is a fatal disease, is contagious, or is a punishment for immoral behavior. Stigma associated with cancer likely contributes to delays in biomedical treatment and shame resulting from a cancer diagnosis may deter use of biomedical screening, resulting in treatment delays. Additional research on the extent and effects of cancer stigma is essential for the development of culturally sensitive interventions that enhance the reach of educational messages and increase adherence with preventive and curative treatments. We approach this gap with a one-year study examining the prevalence of cancer stigma and its impact on access to, and utilization of, cancer prevention, screening, and care services among PLWH populations in Uganda and Zambia. Cancer stigma research is essential for the development of culturally sensitive interventions and has important implications for healthcare providers, policymakers, and public health practitioners working to prevent and control cancer within PLWH in Uganda and Zambia, and other LMICs. The primary partners in the study include the Center for Tobacco Control in Africa at the Makerere University School of Public Health, and the Keck School of Medicine of USC.

项目摘要/摘要 该申请是根据特殊利益通知（NOSI）提交的 23-025“支持全球癌症污名研究的行政补充。癌症杀死了一半以上 每年一百万的非洲人，由于人口等因素，预计在未来十年内利率 生长和衰老，由于对癌症知识有限，缺乏生物医学治疗而导致的诊断延迟， 和污名。传统上，在整个非洲诊断的大多数癌症都是与 病毒感染，尤其是“定义艾滋病的恶性肿瘤”，将艾滋病毒（PLWH）患者放在 与没有的人相比 与艾滋病毒一起生活。增加癌症风险的健康行为（例如使用烟草）也更为普遍 在PLWH中，可以进一步增加定义癌症（NADC）的几种非辅助剂的死亡率。广泛的 已经对HIV污名作为预防HIV，测试和护理的障碍进行了研究。 在我们的家长项目中进行的形成性研究还表明，患者对HIV的利用率 相关的预防癌症和筛查服务的健康中心，包括烟草使用戒烟 干预措施将揭示其艾滋病毒状况。少于PLWH中的癌症污名的研究少得多 社区。癌症的污名可能源自癌症是致命疾病的文化刻板印象，是 具有传染性，或者是对不道德行为的惩罚。与癌症相关的污名可能导致延迟 在癌症诊断引起的生物医学治疗和休克中，可能决定使用生物医学筛查， 导致治疗延迟。关于癌症污名的程度和影响的其他研究对于 开发具有文化敏感干预措施，以增强教育信息的覆盖范围并增加 遵守预防和治疗方法。我们通过一年的研究来解决这一差距 癌症污名的患病率及其对癌症预防，筛查和利用的影响和利用 乌干达和赞比亚的PLWH人群中的护理服务。癌症的污名研究对于 发展文化敏感的干预措施，对医疗保健提供者具有重要意义， 决策者和公共卫生从业人员，努力预防和控制乌干达PLWH内的癌症 和赞比亚和其他LMIC。研究的主要伴侣包括烟草控制中心 非洲在马克雷尔大学公共卫生学院和南加州大学凯克医学院。

项目成果

A phone-based tobacco use cessation program for people living with HIV in Uganda and Zambia: study protocol for a randomized controlled trial.

• DOI: 10.1186/s13722-024-00438-w
• 发表时间: 2024-01-19
• 期刊: ADDICTION SCIENCE & CLINICAL PRACTICE
• 影响因子: 3.7
• 作者: Wipfli, Heather;Arinaitwe, Jim;Goma, Fastone;Atuyambe, Lynn;Guwatudde, David;Phiri, Masauso Moses;Rutebemberwa, Elizeus;Wabwire-Mangen, Fred;Zulu, Richard;Zyambo, Cosmas;Guy, Kyra;Kusolo, Ronald;Mukupa, Musawa;Musasizi, Ezekiel;Tucker, Joan S.
• 通讯作者: Tucker, Joan S.