Funding Opportunity Number: RFA-CA-25-011
Deadline: December 10, 2024
Purpose
Through this notice of funding opportunity (NOFO) as a request for applications (RFA), the National Cancer Institute (NCI) intends to support research that expands the current understanding of the confluence of cancer stigma and HIV stigma among people with HIV (PWH) diagnosed with cancer; assesses the impact of these two converging stigmas on cancer outcomes among PWH with cancer; leverages stigma reduction interventions at multiple levels to intervene on modifiable mechanisms of stigma that contribute to negative cancer outcomes among PWH with cancer; and promotes research in domestic and international contexts, focusing on regions in which the HIV-cancer burden is elevated.
Research Objectives for this NOFO
Traditionally, HIV stigma and cancer stigma have been studied independently. Over the last 40 years, there has been a significant evidence base established regarding the negative effects of HIV stigma, and there is a growing field of research on the negative impacts associated with cancer stigma. However, there is limited research on the confluence of the two stigmas for PWH and cancer. The broader stigma literature suggests that stigmas are not additive but rather interactive, and as such, it is likely that the combination of HIV stigma and cancer stigma has a powerful impact that goes well beyond the effect of either alone. Cancer outcomes hypothesized to be negatively affected by the convergence of HIV stigma and cancer stigma include: healthcare access and utilization; initiation, adherence, and completion of guideline-recommended cancer treatment; patient-centered communication; clinical trial participation; engagement in supportive care services; quality of life and psychosocial well-being; receipt of palliative and/or end-of-life care; financial toxicity; and engagement in healthy behaviors such as tobacco cessation, cancer screening, and monitoring risk of recurrence, among other outcomes. More research is needed to understand – and address – the combined impact of both stigmas on PWH with cancer, particularly given the varying sociocultural and healthcare contexts in the U.S. and around the world.
Examples of research areas include, but are not limited to:
- Studies that develop, adapt, and/or validate measurements that elucidate the mechanisms/pathways by which cancer stigma and HIV stigma affect cancer outcomes among PWH diagnosed with cancer;
- Longitudinal studies to assess the cumulative impact of cancer stigma and HIV stigma on cancer outcomes among PWH diagnosed with cancer;
- Studies examining the intersection of cancer stigma and HIV stigma with sociocultural contexts and other identity-based stigmas (e.g., race and ethnicity, sex and gender) and the impact on cancer outcomes among PWH diagnosed with cancer;
- Studies that elucidate the impact of cancer stigma and HIV stigma on individual agency, resilience, perseverance, social support, and positive coping among PWH diagnosed with cancer, and subsequently on cancer outcomes;
- Studies to reduce stigma associated with behavioral risk factors (e.g., tobacco use, poor nutrition and physical inactivity, alcohol use) that contribute to poor treatment outcomes, cancer recurrence risk, and development of secondary cancers among PWH diagnosed with cancer;
- Studies that develop (or adapt) and evaluate stigma reduction interventions implemented at individual, provider, community, and/or structural levels to improve cancer outcomes in PWH with cancer and investigate mechanisms of intervention effectiveness;
- Studies investigating the impact of the media (traditional and social) in perpetuating and normalizing cancer/HIV stigma among PWH diagnosed with cancer, or conversely, addressing and mitigating related stigma;
- Stigma reduction and communication strategies to mitigate structural and interpersonal cancer stigma/HIV stigma in healthcare settings and improve care coordination between patients and providers to positively affect cancer outcomes among PWH diagnosed with cancer;
- Studies exploring the role of policy interventions and structural changes to reduce cancer stigma and HIV stigma and improve cancer outcomes among PWH diagnosed with cancer
For more detailed information, please see the announcement webpage.