{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:26:41Z","timestamp":1779888401705,"version":"3.53.1"},"reference-count":27,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JGO"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> Health system constraints limit access to HIV and cancer treatment programs in sub-Saharan Africa. Limited access and continuity of care affect morbidity and mortality of patients with cancer and HIV. We assessed barriers in the care cascade of comorbid HIV and cancer. <\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p> Structured interviews were conducted with 100 adult patients with HIV infection and new diagnoses of cancer at the Uganda Cancer Institute. Participants completed follow-up questionnaires after 1 year to assess ongoing engagement with and barriers to care. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> The median time from new-onset cancer symptoms to initiation of cancer care at the Uganda Cancer Institute was 209 days (interquartile range, 113 to 384 days). Persons previously established in HIV care waited less overall to initiate cancer care ( P = .04). Patients established in HIV care experienced shorter times from initial symptoms to seeking of cancer care ( P = .02) and from seeking of care to cancer diagnosis ( P = .048). Barriers to receiving care for HIV and cancer included difficulty traveling to multiple clinics\/hospitals (46%), conflicts between HIV and cancer appointments (23%), prohibitive costs (21%), and difficulty adhering to medications (15%). Reporting of any barriers to care was associated with premature discontinuation of cancer treatment ( P = .003). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Patients with HIV-associated malignancies reported multiple barriers to receiving care for both conditions, although knowledge of HIV status and engagement in HIV care before presentation with malignancy reduced subsequent time to the start of cancer treatment. This study provides evidence to support creation and evaluation of integrated HIV and cancer care models. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jgo.18.00187","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T20:57:06Z","timestamp":1550177826000},"page":"1-8","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":3,"title":["Engagement in HIV Care and Access to Cancer Treatment Among Patients With HIV-Associated Malignancies in Uganda"],"prefix":"10.1200","author":[{"given":"Daniel H.","family":"Low","sequence":"first","affiliation":[{"name":"Swedish Family Medicine Residency at Cherry Hill, Seattle, WA"},{"name":"University of Washington School of Medicine, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren","family":"Phipps","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine, Seattle, WA"},{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Orem","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA"},{"name":"Uganda Cancer Institute, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Casper","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA"},{"name":"Infectious Diseases Research Institute, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel A","family":"Bender Ignacio","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine, Seattle, WA"},{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001056"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-014-0729-8"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-009-9533-2"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0397-1"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030438"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.20.01.21375"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1086\/652283"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60604-8"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32830007cd"},{"key":"B10","first-page":"1","volume":"4","author":"Bender Ignacio R","year":"2018","journal-title":"J Glob Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000433236.55937.cb"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2017.09.007"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.16.2100"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0387"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-7-21"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19840501)53:9<2002::AID-CNCR2820530933>3.0.CO;2-W"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2011.010113"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/1750-9378-9-17"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2008.04.023"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2014-0493"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12025"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000254"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001906"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2018.7057"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.2165\/11591360-000000000-00000"},{"key":"B29","unstructured":"World Health Organization: A guide to monitoring and evaluation for collaborative TB\/HIV activities. https:\/\/www.who.int\/tb\/publications\/monitoring-evaluation-collaborative-tb-hiv\/en\/"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60409-6"}],"container-title":["Journal of Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JGO.18.00187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T10:57:25Z","timestamp":1653821845000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JGO.18.00187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1200\/JGO.18.00187"],"URL":"https:\/\/doi.org\/10.1200\/jgo.18.00187","relation":{},"ISSN":["2378-9506"],"issn-type":[{"value":"2378-9506","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]},"assertion":[{"value":"2019-02-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}