HIV/AIDS-Related Cancers among Racial/Ethnic Minority and Underserved Persons
Erica Lubetkin, MD, MPH and Jack E. Burkhalter, PhD
Persons living with HIV/AIDS (PLWHA) have seen greatly improved life expectancy due to the introduction of antiretroviral medications for long-term management of HIV disease. As such, concern about other threats to health and longevity, such as tobacco use and cancer, have grown. Persons living with HIV/AIDS (PLWHA) are at higher risk for multiple cancers, including AIDS-defining cancers (non-Hodgkin lymphoma, Kaposi sarcoma, and invasive cervical cancer), and non-AIDS-defining cancers, i.e., cancers of the lung, oral cavity/pharynx, and larynx, and cancers of the pancreas, liver, kidney, colon, rectum, and anus. Indeed, some 25% of all AIDS deaths are due to non-HIV-related causes, and non-HIV-related cancers contribute substantially to this mortality. Although HIV-associated impairments in immune integrity may place PLWHA at greater risk for cancer, lifestyle factors come into play as well. For example, smoking prevalence among PLWHA is exceedingly high, as evidenced by estimated prevalence rates of 45-74% compared to 19.8% in the general population. Adding to this cancer burden is poverty, as AIDS incidence has been closely linked to economic deprivation. The CDC estimates that 57.1% of PLWHA have annual incomes below $10,000, and 67.4% are unemployed. Rates of HIV infection are disproportionately elevated among low income African Americans and Hispanics/Latinos, a vulnerable population that experiences disparities in cancer outcomes as well. Within this context, the intersection of HIV/AIDS and cancer poses new challenges to communities serving PLWHA and academic researchers dedicated to reducing health disparities.
This study will focus on building a community-academic partnership and infrastructure to identify and address the needs of the underserved PLWHA at risk for HIV/AIDS-related cancers. The proposed project is highly consistent with the U54’s aims and builds upon the strengths of the MSKCC/CCNY Partnership. Objectives: (1) To develop a collaborative research partnership (HIV/AIDS and Cancer Community Research Collaboration (HAC/CRC) with community-based organizations serving underserved and racial/ethnic minority persons living with HIV/AIDS (PLWHA). (2) To explore and identify specific mutual interests at the convergence of HIV/AIDS and cancer, including cancer prevention (e.g., tobacco use cessation), early detection (cancer screening), and access to treatment (AIDS Malignancy Consortium trial participation, identifying barriers to timely, culturally sensitive treatment). (3) To conduct a community needs assessment based on identified mutual interests at the convergence of HIV/AIDS and cancer.