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

项目摘要/摘要 本申请是对特别利益通知(NOSI)的回应，该通知被标识为“非CA-CA- 23-025“支持全球癌症污名研究的行政副刊”。癌症导致一半以上的人死亡 每年有100万非洲人，由于人口等因素，预计未来十年这一比例还会上升 生长和衰老，癌症知识有限导致的延误诊断，缺乏生物医学治疗， 和耻辱。传统上，整个非洲被诊断出的大多数癌症都与 病毒感染，特别是艾滋病定义的恶性肿瘤，使艾滋病毒携带者(PLWH)处于一种 与未患癌症的人相比，被诊断为癌症并死于癌症的风险要高得多 艾滋病毒携带者。增加癌症风险的健康行为，如吸烟，也更为普遍 并可进一步增加几种非艾滋病定义癌症(NADCs)的死亡率。广泛性 已经开展了关于艾滋病毒污名作为艾滋病毒预防、检测和护理的障碍的影响的研究。 在我们的父母项目中进行的形成性研究也显示，患者对艾滋病毒的恐惧利用- 相关健康中心提供癌症预防和筛查服务，包括戒烟 干预措施，将揭示他们的艾滋病毒状况。关注PLWH内癌症污名的研究要少得多 社区。癌症的污名可能源于文化上的刻板印象，即癌症是一种致命的疾病 传染性，或者说是对不道德行为的惩罚。与癌症相关的耻辱可能是延误的原因 在生物医学治疗中，癌症诊断导致的耻辱可能会阻碍生物医学筛查的使用， 导致治疗延误。关于癌症污名的范围和影响的更多研究对于 制定对文化敏感的干预措施，以加强教育信息的传播，并增加 坚持预防性和治愈性治疗。我们通过一项为期一年的研究来解决这一差距 癌症污名的流行及其对获得和利用癌症预防、筛查和治疗的影响 乌干达和赞比亚妇幼保健院人口的护理服务。癌症污名研究对 制定对文化敏感的干预措施，并对医疗保健提供者具有重要影响， 在乌干达，政策制定者和公共卫生从业人员致力于预防和控制乌干达公共卫生部门的癌症 和赞比亚，以及其他LMIC。这项研究的主要合作伙伴包括#年烟草控制中心 在马凯雷雷大学公共卫生学院和南加州大学凯克医学院的非洲。

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.