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.

项目概要/摘要 本申请是为了响应被标识为“NOT-CA-”的特殊利益通知 (NOSI) 而提交的。 23-025”支持全球癌症耻辱研究的行政补充文件癌症导致一半以上死亡。 每年有 100 万非洲人，由于人口等因素，这一比例预计在未来十年内会上升 生长和衰老、由于对癌症的了解有限而导致的延迟诊断、缺乏生物医学治疗、 传统上，整个非洲诊断出的大多数癌症都是与耻辱相关的类型。 病毒感染，特别是“艾滋病定义的恶性肿瘤”，它使艾滋病毒感染者（PLWH）处于危险境地 与未患癌症的人相比，被诊断患有癌症和死于癌症的风险明显更高 感染艾滋病毒的健康行为（例如吸烟）也更为普遍。 PLWH 中，可能会进一步增加多种非艾滋病定义的癌症 (NADC) 的死亡率。 已经开展了关于艾滋病毒耻辱作为艾滋病毒预防、检测和护理障碍的影响的研究。 我们的家长项目中进行的形成性研究还表明，患者害怕利用艾滋病毒 - 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，而很少有研究关注感染者的癌症耻辱感。 癌症耻辱可能源于癌症是一种致命疾病的文化刻板印象。 具有传染性，或者是对与癌症相关的不道德行为的惩罚，可能会导致延误。 生物医学治疗和癌症诊断带来的耻辱可能会阻碍生物医学筛查的使用， 导致治疗延误的进一步研究对于癌症耻辱的程度和影响至关重要。 制定对文化敏感的干预措施，增强教育信息的影响力并提高 我们通过一项为期一年的研究来弥补这一差距。 癌症耻辱感的盛行及其对癌症预防、筛查和治疗的获取和利用的影响 乌干达和赞比亚的感染者和艾滋病患者的护理服务对于癌症耻辱研究至关重要。 制定文化敏感的干预措施并对医疗保健提供者具有重要影响， 乌干达政策​​制定者和公共卫生从业者致力于预防和控制艾滋病毒感染者的癌症 该研究的主要合作伙伴包括赞比亚和其他中低收入国家的烟草控制中心。 非洲在麦克雷雷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.

针对乌干达和赞比亚艾滋病毒感染者的基于电话的戒烟计划：随机对照试验的研究方案。

• 发表时间: 2024-01-19
• 影响因子: 3.7
• 作者: Wipfli, Heather;Arinaitwe, Jim;Goma, Fastone;Atuyambe, Lynn;Guwatudde, David;Phiri, Masauso Moses;Rutebemberwa, Elizeus;Wabwire;Zulu, Richard;Zyambo, Cosmas;Guy, Kyra;Kusolo, Ronald;Mukupa, Musawa;Musasizi, Ezekiel;Tucker, Joan
• 通讯作者: Tucker, Joan