HIV, cancer, and coping: The cumulative burden of a cancer diagnosis among people living with HIV

Abstract

Objectives

People living with HIV (PLWH) have increased risk for cancer and worse cancer-specific survival. We explored the emotional burden of cancer and HIV as a potential driver of cancer mortality.

Research Approach

Semi-structured qualitative interviews with PLWH and cancer.

Participants

27 PLWH who had either completed cancer treatment, were currently undergoing treatment, or experienced challenges in completing treatment.

Methodological Approach

An inductive qualitative approach using the constant comparative method.

Findings

Participants drew strong parallels between being diagnosed with HIV and cancer. Many described HIV-related stigma that hindered social support. Cancer treatment side effects were a major challenge, impacting treatment adherence for both cancer and HIV.

Implications for Psychosocial Providers

There is a need for convenient, affordable, and visible services to support PLHIV as they navigate cancer care. Services should be tailored to the unique needs of this population by addressing HIV-related stigma, building social support, and fostering resilience.

Keywords:

• Dual burden of HIV and cancer
• health disparities
• HIV-associated comorbidities
• qualitative research
• malignancies
• mental health
• HIV stigma

Acknowledgements

The authors would like to acknowledge Bijal Shah, MS from the Department of Radiation Oncology, Duke Cancer Institute, for her assistance in study recruitment and the Duke Center for AIDS Research Community Advisory Board (CFAR CAB) for their assistance in developing and piloting the study interview guide and interpreting the findings.

Author contributions

All authors meet ICMJE criteria for inclusion. BK, KC, MW, and GS contributed to study design, data collection, data analysis, data interpretation and writing. EC and NH contributed to data analysis, data interpretation and writing. SC and JC contributed to study design, ethical and regulatory support and manuscript review. JC and PU contributed to data interpretation and manuscript review.

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

This project was supported by Duke Cancer Institute’s Cancer Control and Population Sciences Pilot Grant. The authors would also like to acknowledge support received by the Duke University Center for AIDS Research (CFAR; 5P30 AI064518) and the National Cancer Institute (K08 CA228631).