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Cancer Treatment Decision-Making for People Living With HIV: Physician-Reported Barriers, Facilitators, and Recommendations.

Publication ,  Journal Article
Khouri, A; Stephens, MJ; Young, J; Galyean, P; Knettel, BA; Cherenack, EM; Zickmund, S; Watt, MH; Bartlett, J; Pollak, KI; Ubel, PA; Suneja, G ...
Published in: J Acquir Immune Defic Syndr
December 15, 2023

BACKGROUND: Compared with the general cancer population, people living with HIV (PLWH) and cancer are less likely to receive treatment and have significantly elevated cancer-specific mortality for many common cancer types. Physician recommendations drive the cancer therapy that patients receive, yet there is limited information assessing how cancer treatment decisions are made for people living with HIV and cancer. We sought to understand oncologist decision-making in PLWH and cancer by eliciting barriers, facilitators, and recommendations for enhancing care delivery. SETTING: Participants were recruited between May 2019 and May 2021 from one academic medical center in the western United States (n = 13), another in the southeastern United States (n = 7), and community practices nationwide (n = 5). METHODS: Using an inductive qualitative approach, we conducted in-depth interviews with 25 oncologists from two academic medical centers and community practices. RESULTS: Facilitators of cancer care delivery included readily available information regarding HIV status and stage, interdepartmental communication, and antiviral therapy adherence. Barriers included a lack of formal education on HIV malignancies, perceptions of decreased life expectancy, fear of inadvertent disclosure, and drug-drug interactions. Recommendations included improved provider communication, patient social and mental health resources, and continuing education opportunities. CONCLUSION: The study revealed drivers of cancer treatment decision-making, highlighting physician-reported barriers and facilitators, and recommendations to support treatment decision-making. This is the first known study examining oncologists' perceptions of caring for PLWH. Given that cancer is a leading cause of death among PLWH, there is an urgent need to improve care and outcomes.

Duke Scholars

Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

December 15, 2023

Volume

94

Issue

5

Start / End Page

482 / 489

Location

United States

Related Subject Headings

  • Virology
  • United States
  • Qualitative Research
  • Physicians
  • Patient Compliance
  • Neoplasms
  • Humans
  • HIV Infections
  • Communication
  • 4206 Public health
 

Citation

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Khouri, A., Stephens, M. J., Young, J., Galyean, P., Knettel, B. A., Cherenack, E. M., … Suneja, G. (2023). Cancer Treatment Decision-Making for People Living With HIV: Physician-Reported Barriers, Facilitators, and Recommendations. J Acquir Immune Defic Syndr, 94(5), 482–489. https://doi.org/10.1097/QAI.0000000000003300
Khouri, Ashley, Maya J. Stephens, Jeanette Young, Patrick Galyean, Brandon A. Knettel, Emily M. Cherenack, Susan Zickmund, et al. “Cancer Treatment Decision-Making for People Living With HIV: Physician-Reported Barriers, Facilitators, and Recommendations.J Acquir Immune Defic Syndr 94, no. 5 (December 15, 2023): 482–89. https://doi.org/10.1097/QAI.0000000000003300.
Khouri A, Stephens MJ, Young J, Galyean P, Knettel BA, Cherenack EM, et al. Cancer Treatment Decision-Making for People Living With HIV: Physician-Reported Barriers, Facilitators, and Recommendations. J Acquir Immune Defic Syndr. 2023 Dec 15;94(5):482–9.
Khouri, Ashley, et al. “Cancer Treatment Decision-Making for People Living With HIV: Physician-Reported Barriers, Facilitators, and Recommendations.J Acquir Immune Defic Syndr, vol. 94, no. 5, Dec. 2023, pp. 482–89. Pubmed, doi:10.1097/QAI.0000000000003300.
Khouri A, Stephens MJ, Young J, Galyean P, Knettel BA, Cherenack EM, Zickmund S, Watt MH, Bartlett J, Pollak KI, Ubel PA, Fagerlin A, Suneja G. Cancer Treatment Decision-Making for People Living With HIV: Physician-Reported Barriers, Facilitators, and Recommendations. J Acquir Immune Defic Syndr. 2023 Dec 15;94(5):482–489.

Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

December 15, 2023

Volume

94

Issue

5

Start / End Page

482 / 489

Location

United States

Related Subject Headings

  • Virology
  • United States
  • Qualitative Research
  • Physicians
  • Patient Compliance
  • Neoplasms
  • Humans
  • HIV Infections
  • Communication
  • 4206 Public health