Key Dates
None
National Cancer Institute (NCI)
The National Cancer Institute intends to promote a new initiative by publishing a Notice of Funding Opportunity (NOFO) to solicit applications for research on the confluence of cancer stigma and HIV stigma in HIV-positive individuals diagnosed with cancer. This NOFO will utilize the R01 grant mechanism (clinical trial optional). Up to six (6) R01 awards are expected to be funded as part of the initiative.
Research projects search project will advance the current understanding of the confluence of cancer stigma and HIV stigma among people with HIV (PWH) diagnosed with cancer; assess the impact of these two converging stigmas on cancer outcomes among PWH with cancer; leverage stigma reduction interventions at multiple levels to intervene on modifiable mechanisms of stigma that contribute to negative cancer outcomes among PWH with cancer; and promote research in diverse domestic and international contexts, focusing on regions in which the HIV-cancer burden is elevated.
The NOFO is expected to be published in late Summer 2024 with an expected application due date in late Fall 2024. Details of a pre-application webinar will be announced after the publication of the NOFO. This Notice is being provided to allow sufficient time for potential applicants with relevant expertise and insights to consider applying for this NOFO.
Potential applicants are encouraged to view the presentation of this initiative to the Joint Virtual Meeting of the NCI Board of Scientific Advisors and the National Cancer Advisory Board available at https://videocast.nih.gov/watch=54859 beginning at 3 hour, 39 minutes. Presentation slides are downloadable at: https://deainfo.nci.nih.gov/advisory/joint/0624/Vanderpool.pdf.
In 2022, there were approximately 39 million people with HIV (PWH) worldwide and over 1 million PWH in the United States. Compared to the general population, PWH have an elevated risk of cancer overall, and an increased risk for specific cancers due to coinfection with oncogenic viruses, behavioral risk factors, cancer and aging, and/or other sociocultural factors. In 2020, in the U.S., there were approximately 8,000 incident cancer diagnoses among PWH. Although there is limited data on the estimated cancer burden among PWH globally, existing data suggest that co-occurring HIV infection and cancer diagnosis are concentrated in low- and middle-income countries. For example, the largest burden of both HIV-attributable cervical cancer and HIV-attributable Kaposi sarcoma is in eastern and southern Africa.
Compared to HIV-uninfected cancer patients, PWH diagnosed with cancer have poorer cancer-specific survival and increased cancer mortality rates. These negative outcomes result from a combination of patient-, provider-, and system-level factors, including the powerful social phenomenon of stigma. Stigma is a well-documented social process characterized by negative beliefs, attitudes, and stereotypes associated with specific attributes or characteristics – such as being diagnosed with HIV or cancer – that leads to labeling, devaluation, blame, discrimination, and social rejection. The NOFO focuses on individuals with a dual diagnosis of HIV and cancer as they have increased risk of negative cancer outcomes given they experience stigma associated with both health attributes.
Traditionally, HIV stigma and cancer stigma have been studied independently; however, there is limited research on the confluence of the two stigmas for PWH and cancer and the impact on cancer outcomes for these patients. 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 diverse sociocultural and healthcare contexts in the U.S. and around the world.
Given the premise of the NOFO, applications must examine the interaction of HIV stigma and cancer stigma among PWH with cancer, specifically within the adult patient population. In addition, applications must consider the intersection of other relevant identity-based stigmas such as race/ethnicity, socioeconomic status, occupation, class, and sexual and gender identity as appropriate. Investigators will be also asked to carefully consider and justify the geographical and sociocultural contexts of the proposed study population, focusing on regions in which the HIV-cancer burden is particularly high (e.g., southern U.S., major U.S. cities, African countries, Southeast Asia). Collaborations with stakeholders of the HIV-cancer community (e.g., patients, caregivers, providers, health systems, community organizations) are strongly encouraged.
Cancer outcomes are of primary interest and required by the NOFO, however, applications may also include HIV outcomes.
All applications should consider the multilevel nature of stigma, spanning from individual to structural levels. Specifically, applications proposing interventional research must address stigma at two or more levels.
Funding Information
Up to $5M for FY2025
6
Direct costs in any single year should reflect the actual needs of the proposed project; however, total direct costs are limited to $500,000 in direct costs/year.
93.393
Private Institution of Higher Education
Nonprofit with 501(c)(3) IRS Status (Other than Institution of Higher Education)
Small Business
For-Profit Organization (Other than Small Business)
State Government
Indian/Native American Tribal Government (Federally Recognized)
County governments
Independent school districts
Public housing authorities/Indian housing authorities
Indian/Native American Tribally Designated Organization (Native American tribal organizations (other than Federally recognized tribal governments)
U.S. Territory or Possession
Indian/Native American Tribal Government (Other than Federally Recognized)
Non-domestic (non-U.S.) Entity (Foreign Organization)
Regional Organization
Eligible Agencies of the Federal Government
Applications are not being solicited at this time.
Inquiries
Please direct all inquiries to:
Robin C. Vanderpool, DrPH
National Cancer Institute/Division of Cancer Control and Population Sciences
Telephone: 240-276-6558
Email: robin.vanderpool@nih.gov
Rebecca Ferrer, PhD
National Cancer Institute/Division of Cancer Control and Population Sciences
Telephone: 301-852-1167
Email: rebecca.ferrer@nih.gov
and Human Services (HHS)
