RISE: Reducing Cancer and HIV Stigma Through Empowerment
M.D. Anderson Cancer Center
Summary
This multilevel randomized behavioral study evaluates participant- and provider-level stigma-reduction interventions in Zambia. Participant-level intervention: Women living with cervical cancer and HIV (WLC+H ) are randomized in a 2×2 factorial design of storytelling versus neutral videos and storytelling versus neutral disclosure interventions to assess effects on quality of life, anxiety, and depressive symptoms. Provider-level intervention: Healthcare workers are randomized to storytelling or neutral videos to assess changes in stigma and compassion. The study also evaluates participant -reported stigma and satisfaction with care before and after implementation of the provider intervention.
Description
People living with HIV face a substantially elevated risk of developing cancers due to compromised immunity. Among women, HIV significantly increases vulnerability to oncogenic human papillomavirus (HPV) infection, the primary cause of cervical cancer. This dual burden of cervical cancer and HIV disproportionately impacts low- and middle-income countries (LMICs), with Zambia exemplifying this crisis. Outcomes for affected individuals living with cervical cancer and HIV in LMICs are poor, with a one-year survival rate of just 65%. Addressing this intertwined public health challenge in LMICs is…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: Patient-level intervention 1. Women diagnosed with cervical cancer and HIV (stage I-IV) 2. Receiving cancer treatment at the Cancer Disease Hospital in Zambia 3. Aged 18 or above 4. Able to speak in English (the official language in Zambia) or one of four local languages (Bemba, Nyanja, Tonga, Lozi) for cultural inclusivity Provider-level intervention 1\. Employment at the Cancer Disease Hospital in Lusaka, Zambia Exclusion Criteria: Patient-level intervention 1.Inability to provide informed consent and presence of a major mental health disorder (e.g., schizophrenia…
Interventions
- BehavioralNeutral Video
Participants in the control group will watch neutral videos and describe objective, non-emotional objects/events
- BehavioralStorytelling
The storytelling intervention group will watch the storytelling videos and then describe objective, non-emotional objects/events.
- BehavioralSelf disclosure
Participants will watch neutral videos and then talk/write about their cancer/HIV-related experiences to themselves.
- BehavioralCombination
The combination group will watch the storytelling videos and then talk/write about their cancer/HIV-related experiences to themselves.
- BehavioralVideo
Participants (healthcare workers) will watch storytelling videos in a group setting, followed by a facilitated discussion and role-playing to enhance empathy and understanding.
- BehavioralWaitlist
Location
- UT MD AndersonHouston, Texas