R01TW012415
Project Grant
Overview
Grant Description
A Stigma Responsive Service Delivery Model for HPV-Based Screening Among Women Living with HIV - Abstract
Women living with HIV (WLWH) are at increased biological risk for infection with human papillomavirus (HPV) and development of pre-invasive and invasive cervical cancer. The World Health Organization has recently called for HIV-programs to bolster their efforts to prevent cervical cancer through integrated screening services.
Understanding and addressing stigma, including the intersection of HIV, HPV, and cervical cancer-related stigma, will be crucial to designing interventions that will facilitate the uptake of cancer screening among WLWH and women in high HIV prevalence settings like Western Kenya. Cancer-related stigma negatively influences several determinants of cancer screening uptake, including perception of cancer risk, cancer screening benefit, and acceptability of screening methods.
In our prior work to evaluate HPV-based screening in Kenya, we found that lack of education about cervical cancer and low awareness of screening benefits, both of which can potentiate cancer-related stigma, were major barriers to screening uptake. Our team also found that misperceptions and stigma about an HPV diagnosis and cancer were associated with reduced rates of follow-up among women who tested positive for HPV.
Our team developed a stigma framework to inform and validate a measurement tool for HPV-, cervical cancer-, and HIV-related stigmas. We found that educational messages focused on cancer-related outcomes and HPV epidemiology, including risks related to sexual behavior and HIV, were stigmatizing, while support from social networks and emphasis on the availability of effective treatment reduced stigma and promoted screening uptake.
We used this data to develop a stigma-responsive educational intervention which includes simplified scripts for multiple cadres of health workers that provide clear messages about HPV and the benefits of screening, and a video aimed at addressing fears and misperceptions from a peer perspective. We propose to incorporate these educational components into "Elimisha HPV," a multilevel stigma-responsive cervical cancer prevention service delivery model for integration within clinics providing HIV-care in Western Kenya.
Elimisha HPV, which in Kiswahili means to increase understanding of HPV, will include the following components: HPV-testing via self-collection, simplified scripts and video, peer navigators for women with screening or treatment hesitancy, and the option to receive results and information via text messages.
To adapt, implement, and test the effectiveness of this model, we will:
1) Work with key stakeholders to finalize Elimisha HPV
2) Compare cervical cancer prevention outcomes and engagement in HIV care in clinics offering the Elimisha HPV model to clinics providing standard of care outreach, education, and screening strategies
3) Identify individual and institutional factors that moderate the effects of Elimisha HPV on cervical cancer prevention outcomes.
If effective, this may represent a new model for HPV-based cervical cancer screening as well as a new paradigm for comprehensive, stigma-responsive service delivery packages for people living with HIV.
Women living with HIV (WLWH) are at increased biological risk for infection with human papillomavirus (HPV) and development of pre-invasive and invasive cervical cancer. The World Health Organization has recently called for HIV-programs to bolster their efforts to prevent cervical cancer through integrated screening services.
Understanding and addressing stigma, including the intersection of HIV, HPV, and cervical cancer-related stigma, will be crucial to designing interventions that will facilitate the uptake of cancer screening among WLWH and women in high HIV prevalence settings like Western Kenya. Cancer-related stigma negatively influences several determinants of cancer screening uptake, including perception of cancer risk, cancer screening benefit, and acceptability of screening methods.
In our prior work to evaluate HPV-based screening in Kenya, we found that lack of education about cervical cancer and low awareness of screening benefits, both of which can potentiate cancer-related stigma, were major barriers to screening uptake. Our team also found that misperceptions and stigma about an HPV diagnosis and cancer were associated with reduced rates of follow-up among women who tested positive for HPV.
Our team developed a stigma framework to inform and validate a measurement tool for HPV-, cervical cancer-, and HIV-related stigmas. We found that educational messages focused on cancer-related outcomes and HPV epidemiology, including risks related to sexual behavior and HIV, were stigmatizing, while support from social networks and emphasis on the availability of effective treatment reduced stigma and promoted screening uptake.
We used this data to develop a stigma-responsive educational intervention which includes simplified scripts for multiple cadres of health workers that provide clear messages about HPV and the benefits of screening, and a video aimed at addressing fears and misperceptions from a peer perspective. We propose to incorporate these educational components into "Elimisha HPV," a multilevel stigma-responsive cervical cancer prevention service delivery model for integration within clinics providing HIV-care in Western Kenya.
Elimisha HPV, which in Kiswahili means to increase understanding of HPV, will include the following components: HPV-testing via self-collection, simplified scripts and video, peer navigators for women with screening or treatment hesitancy, and the option to receive results and information via text messages.
To adapt, implement, and test the effectiveness of this model, we will:
1) Work with key stakeholders to finalize Elimisha HPV
2) Compare cervical cancer prevention outcomes and engagement in HIV care in clinics offering the Elimisha HPV model to clinics providing standard of care outreach, education, and screening strategies
3) Identify individual and institutional factors that moderate the effects of Elimisha HPV on cervical cancer prevention outcomes.
If effective, this may represent a new model for HPV-based cervical cancer screening as well as a new paradigm for comprehensive, stigma-responsive service delivery packages for people living with HIV.
Awardee
Funding Goals
THE JOHN E. FOGARTY INTERNATIONAL CENTER (FIC) SUPPORTS RESEARCH AND RESEARCH TRAINING TO REDUCE DISPARITIES IN GLOBAL HEALTH AND TO FOSTER PARTNERSHIPS BETWEEN U.S. SCIENTISTS AND THEIR COUNTERPARTS ABROAD. FIC SUPPORTS BASIC BIOLOGICAL, BEHAVIORAL, AND SOCIAL SCIENCE RESEARCH, AS WELL AS RELATED RESEARCH TRAINING AND CAREER DEVELOPMENT. THE RESEARCH PORTFOLIO IS DIVIDED INTO SEVERAL PROGRAMS THAT SUPPORT A WIDE VARIETY OF FUNDING MECHANISMS TO MEET PROGRAMMATIC OBJECTIVES.
Grant Program (CFDA)
Awarding Agency
Place of Performance
Durham,
North Carolina
277103038
United States
Geographic Scope
Single Zip Code
Related Opportunity
Analysis Notes
Amendment Since initial award the total obligations have increased 606% from $100,000 to $706,250.
Duke University was awarded
Stigma-Responsive HPV Screening for WLWH
Project Grant R01TW012415
worth $706,250
from the National Institute of Allergy and Infectious Diseases in July 2022 with work to be completed primarily in Durham North Carolina United States.
The grant
has a duration of 3 years and
was awarded through assistance program 93.310 Trans-NIH Research Support.
The Project Grant was awarded through grant opportunity Interventions for Stigma Reduction to Improve HIV/AIDS Prevention, Treatment and Care in Low- and Middle- Income Countries (R01 - Clinical Trial Optional).
Status
(Complete)
Last Modified 10/21/24
Period of Performance
7/20/22
Start Date
6/30/25
End Date
Funding Split
$706.2K
Federal Obligation
$0.0
Non-Federal Obligation
$706.2K
Total Obligated
Activity Timeline
Subgrant Awards
Disclosed subgrants for R01TW012415
Transaction History
Modifications to R01TW012415
Additional Detail
Award ID FAIN
R01TW012415
SAI Number
R01TW012415-3548138207
Award ID URI
SAI UNAVAILABLE
Awardee Classifications
Private Institution Of Higher Education
Awarding Office
75NF00 NIH FOGARTY INTERNATIONAL CENTER
Funding Office
75NA00 NIH OFFICE OF THE DIRECTOR
Awardee UEI
TP7EK8DZV6N5
Awardee CAGE
4B478
Performance District
NC-04
Senators
Thom Tillis
Ted Budd
Ted Budd
Budget Funding
| Federal Account | Budget Subfunction | Object Class | Total | Percentage |
|---|---|---|---|---|
| John E. Fogarty International Center, National Institutes of Health, Health and Human Services (075-0819) | Health research and training | Grants, subsidies, and contributions (41.0) | $225,611 | 53% |
| National Cancer Institute, National Institutes of Health, Health and Human Services (075-0849) | Health research and training | Grants, subsidies, and contributions (41.0) | $200,000 | 47% |
Modified: 10/21/24