Patients with human immunodeficiency virus (HIV) are less likely to receive potentially life-saving cancer treatment if they reside in communities with lower income levels and educational attainment, according to a recent study published by Islam et al in Cancer.
Study Methods and Results
Investigators analyzed the cancer treatment records of over 31,000 adult patients with HIV who were diagnosed with one of 14 types of cancers between 2004 and 2020. Most of the patients involved in the study were male (68%), aged 60 years or older (43%), and from the southern United States (39%). Lung cancer, lymphoma, colorectal cancer, and prostate cancer were the most commonly diagnosed malignancies.
The investigators found that 16.5% of the patients didn’t receive the recommended first-line curative treatments for their cancers; this gap in care was strongly linked to where the patients resided. Patients with HIV living in zip codes with the lowest educational attainment had a 27% lower likelihood of receiving curative cancer treatments compared with those living in the areas with the highest educational attainment. Similarly, those residing in the communities with the lowest income levels were also 27% less likely to receive treatment—even after accounting for age, sex, cancer type, stage at diagnosis, and treatment facility.
“These disparities suggest that structural factors, not just individual health or medical complexity, may be driving inequities in cancer care for [patients] with HIV,” indicated co–study author Ami Alishahi Tabriz, MD, PhD, MPH, an assistant member of the Health Outcomes and Behavior Program at the Moffitt Cancer Center. “We need to ensure that every patient, regardless of zip code, has equal access to life-saving cancer treatment,” he added.
Conclusions
The study highlighted the need for policies and community-level interventions that address social factors of health—such as access to education and economic opportunity—to ensure equitable cancer care among all patients, regardless of HIV status.
“Our findings show that where [a patient] lives, specifically the income and education level of their community, can play a critical role in whether they get the cancer care they need,” stressed lead study author Jessica Islam, PhD, MPH, an assistant member of the Cancer Epidemiology Program at the Moffitt Cancer Center. “This isn’t just about access to treatment facilities. It’s about the larger social and economic structures that shape health outcomes. Creating interventions to address these factors is essential to closing the gap in cancer care for [patients] with HIV,” she concluded.
Disclosure: The research in this study was supported by The American Cancer Society. For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
