HIV and Cancer Interaction Highlights Need to Address Disease Stigma
, by Laura Wagstaff
The global landscape of disease often draws attention to disparities that exist between nations. An estimated 36 million people worldwide live with HIV and AIDS, of which only 1 million are located within the United States. While the diagnosis of a life-threatening disease can be devastating, individuals with HIV and AIDS frequently bear an additional burden of stigma and discrimination.
Stigma in the HIV-positive population is a manifestation of self or societal disapproval and can discourage screening, limit access to care, and reduce adherence to treatment, especially in low- and middle-income countries (LMICs). In 2001, an HIV Stigma Scale was developed to categorize personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes toward people with HIV. Since then, the measurement tool has been used around the world to understand the structural and interpersonal factors that may impact feelings of stigma within the HIV and AIDS populations. Despite progress understanding the disease and associated societal complications, certain research gaps within the topic remain. The US National Cancer Institute (NCI) has joined The Fogarty International Center and National Institute of Mental Health in participating in a new funding opportunity focused on Reducing Stigma to Improve HIV/AIDS Prevention, Treatment, and Care in Low and Middle-Income Countries (R21).
People Living with HIV/AIDS (PLWH) often suffer from additional communicable and non-communicable diseases, including cancer, that also have associated stigma. For example, lifestyle behaviors such as smoking or alcohol consumption are often tied to lung and kidney cancers, respectively; cervical cancer can be caused by a sexually transmitted virus and associated with HIV positivity. The complex effect of stigma associated with comorbidities imposes an added burden on this population. This is especially true within LMICs, where limited resources or cultural misconceptions may exacerbate an already difficult situation.
Improving the knowledge base of the major contributors to stigma is key to developing appropriate responses to the underlying conditions. NCI is interested in funding evidence-based studies, interventions or measurement tools that work to understand or reduce cancer stigma against PLWH, as well as stigma towards and/or by family members or caregivers of PLWH. By addressing the challenges that LMICs may face with illness-related stigma paradigms, NCI aims to support improved global cancer care and control for some of the world’s most vulnerable populations.
For additional information on NCI’s participation in this funding announcement, please contact Vidya Vedham at vidya.vedham@nih.gov.