Supportive Care for People Living with HIV and Cancer in the United States

Abstract

People with HIV (PWH) in the United States (US) are living longer and are aging into demographic groups in which chronic conditions such as cancer, specifically non-AIDS defining cancers, more commonly occur. Not only do PWH have higher rates of these cancers, but they are also more likely to experience higher, stage-adjusted, cancer-specific mortality compared to their HIV-negative counterparts. One important contributing factor is the disparity in the type of treatment offered to cancer patients with HIV. In a study comparing the use of palliative care among patients with cancer living with and without HIV in the US, researchers found that among those diagnosed with early stage-cancer, PWH had 96% higher odds of receiving palliative care versus those without HIV. On the other hand, among those diagnosed with stage 4 cancer, PWH had 30% lower odds of receiving palliative care compared to their HIV-negative counterparts. The investigators also showed that PWH who did not receive palliative care had 48% lower odds of receiving curative treatment. As for those who did receive palliative care, they were also less likely to receive curative treatment compared to those without HIV, suggesting that PWH were receiving palliative care in lieu of curative treatment. These findings reinforce prior data that curative treatment is not routinely offered to PWH in an equitable way and underscore the importance of developing efforts to improve outcomes in this marginalized population.