{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:21:06Z","timestamp":1792614066497,"version":"4.5.0"},"reference-count":35,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Breast cancer (BC) is the most frequently diagnosed cancer among women globally. In sub-Saharan Africa, its impact is compounded by high HIV prevalence. Studies show that women living with HIV and BC (WLHIVBC) often present at advanced stages despite contact with HIV Care and Treatment Clinics. Little is known about their experiences in navigating both conditions. This study explored barriers and facilitators to integrated care for WLHIVBC in Tanzania to inform development of a patient-centered care model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This qualitative study used a grounded theory approach, conducting 21 in-depth interviews with 11 WLHIVBC and 10 health care providers (oncologists, infectious-disease specialists, nurses, and pharmacists) over 10 months. Analysis followed an iterative coding process using Dedoose, and a multidisciplinary team refined key themes shaping the proposed integrated care model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Participants described barriers including stigma, nondisclosure, logistical and financial constraints, fragmented services, psychological burden, and reliance on spiritual healing. Facilitators included trust in providers, colocated services, patient education, peer support, and psychosocial counseling. Faith played a dual role\u2014strengthening some while delaying care for others. Participants identified faith-based organizations as partners in education and stigma reduction. Recommendations emphasized colocated clinics, empathetic communication, psychosocial support, and collaboration with the Ministry of Health, Ministry of Education, and faith-based organizations to strengthen community education and linkage to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>WLHIVBC in Tanzania face intersecting burdens of stigma, late presentation, and fragmented services. Yet, trust, peer networks, and education provide clear entry points for integration. Findings call for holistic, patient-centered, multisectoral approaches bridging oncology and HIV care and prioritizing patient experience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00330","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:57:17Z","timestamp":1765832237000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Paving the Way for an Integrated Care Model: Experiences of Women Living With HIV and Breast Cancer in Tanzania"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1295-3197","authenticated-orcid":true,"given":"Sarah Kutika","family":"Nyagabona","sequence":"first","affiliation":[{"name":"Muhimbili National Hospital, Dar es Salaam, Tanzania"},{"name":"Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4909-3541","authenticated-orcid":true,"given":"Summaiya","family":"Haddadi","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2839-5536","authenticated-orcid":true,"given":"Rachel Jared","family":"Mtei","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3625-0725","authenticated-orcid":true,"given":"Bruno","family":"Sunguya","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crispin","family":"Kahesa","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"},{"name":"Ocean Road Cancer Institute, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles Kisali","family":"Pallangyo","sequence":"additional","affiliation":[{"name":"Muhimbili National Hospital, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9753-3345","authenticated-orcid":true,"given":"Chia-Ching Jackie","family":"Wang","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9705-4114","authenticated-orcid":true,"given":"Katherine","family":"Van Loon","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3768-0225","authenticated-orcid":true,"given":"Elia John","family":"Mmbaga","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"},{"name":"University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_7_2_2","unstructured":"International Agency for Research on Cancer: Global statistics for 2022. 2022. https:\/\/gco.iarc.who.int\/media\/globocan\/factsheets\/populations\/900-world-fact-sheet.pdf"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1079990"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(21)00326-X"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31972"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00198-X"},{"key":"e_1_3_7_7_2","first-page":"6","volume-title":"Tanzania Commission for AIDS (TACAIDS) TTHIS 2022 2023, (THIS 2022-2023): Final Report. Tanzania HIV Impact Survey","year":"2024","unstructured":"Tanzania Commission for AIDS (TACAIDS) TTHIS 2022 2023, (THIS 2022-2023): Final Report. Tanzania HIV Impact Survey. Tanzania, TACAIDS, 2024, pp 6-9"},{"key":"e_1_3_7_8_2","first-page":"659","article-title":"Breast cancer during the HIV epidemic in an African population","volume":"8","author":"Amir H","year":"2001","unstructured":"Amir H, Makwaya C, Mhalu F, et al: Breast cancer during the HIV epidemic in an African population. Oncol Rep 8:659-661, 2001","journal-title":"Oncol Rep"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-013-2606-y"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0002432"},{"key":"e_1_3_7_11_2","first-page":"1","article-title":"Breast cancer and HIV in sub-Saharan Africa: A complex relationship","volume":"4","author":"Grover S","year":"2018","unstructured":"Grover S, Martei YM, Puri P, et al: Breast cancer and HIV in sub-Saharan Africa: A complex relationship. J Glob Oncol 4:1-11, 2018","journal-title":"J Glob Oncol"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0275639"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjon.2024.100502"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2022.1350"},{"key":"e_1_3_7_15_2","unstructured":"World Health Organization guidance on integrating the prevention and control of noncommunicable diseases in HIV\/AIDS tuberculosis and sexual and reproductive health programmes. https:\/\/www.who.int\/news\/item\/05-04-2023-world-health-organization-guidance-on-integrating-the-prevention-and-control-of-noncommunicable-diseases-in-hiv-aids-tuberculosis-and-sexual-and-reproductive-health-programmes"},{"key":"e_1_3_7_16_2","volume-title":"Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory","author":"Corbin J","year":"2015","unstructured":"Corbin J, Strauss A. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 4th ed. Thousand Oaks, CA: SAGE Publications, 2015","edition":"4"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnsa.2024.100199"},{"key":"e_1_3_7_18_2","volume-title":"Constructing Grounded Theory Research","author":"Charmaz K","year":"2014","unstructured":"Charmaz K: Constructing Grounded Theory Research (ed 2). SAGE Publications, 2014. https:\/\/www.torrossa.com\/gs\/resourceProxy?an=5019293&publisher=FZ7200","edition":"2"},{"key":"e_1_3_7_19_2","first-page":"636","article-title":"Breast cancer survival and survival disparities in sub-Saharan Africa: Findings from the ABC-DO study","volume":"21","author":"VA M","year":"2020","unstructured":"VA M, Joffe M, E van den B: Breast cancer survival and survival disparities in sub-Saharan Africa: Findings from the ABC-DO study. Lancet Oncol 21:636-645, 2020","journal-title":"Lancet Oncol"},{"key":"e_1_3_7_20_2","first-page":"1361","article-title":"Human immunodeficiency virus infection in breast cancer patients: The prevalence thereof and its effect on breast cancer characteristics at Dr. George Mukhari Academic Hospital Breast Clinic, Ga-Rankuwa, South Africa","volume":"22","author":"Van Zyl N","year":"2018","unstructured":"Van Zyl N, Minn\u00e9 C, Mokone DH: Human immunodeficiency virus infection in breast cancer patients: The prevalence thereof and its effect on breast cancer characteristics at Dr. George Mukhari Academic Hospital Breast Clinic, Ga-Rankuwa, South Africa. South Afr J Radiol 22:1361, 2018","journal-title":"South Afr J Radiol"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283558430"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trecan.2016.06.007"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2011.552068"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000042"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181f9fb39"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.16.3.18640"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.35376"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003283"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-16616-5"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-025-06836-1"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpab080"},{"key":"e_1_3_7_32_2","volume-title":"Faith-Based Organization Role in Health Systems in Tanzania","author":"Jankowski M","year":"2021","unstructured":"Jankowski M: Faith-Based Organization Role in Health Systems in Tanzania. CCIH, 2021. https:\/\/www.ccih.org\/faith-based-organization-role-in-health-systems-in-tanzania\/"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/wjs.12338"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.7754"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2013.819400"},{"key":"e_1_3_7_36_2","unstructured":"UNAIDS WHO PEPFAR. Task Shifting Global Recommendations and Guidelines HIV\/AIDS. Geneva Switzerland WHO 2007. https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/ttr_taskshifting_en_0.pdf"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO-25-00330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:57:31Z","timestamp":1765832251000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO-25-00330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1200\/GO-25-00330"],"URL":"https:\/\/doi.org\/10.1200\/go-25-00330","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-05","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2500330"}}