At the Integrated Behavioral Health Research Institute (IBHRI), we are committed to advancing the understanding of complex health issues affecting people with HIV (PWH) and their quality of life. One area of growing concern is the rising incidence of non-AIDS defining cancers (NADCs) in PWH, a topic that has not been fully explored despite its critical implications for long-term health outcomes. Our ongoing study aims to bridge this gap by investigating the epidemiology, risk factors, and health outcomes related to NADCs in PWH, particularly focusing on key behavioral and social determinants of health.

Why Study NADCs in People with HIV?

With the success of antiretroviral therapy (ART), PWH are living longer, but this extended lifespan brings with it new health challenges. Among these is the increased prevalence of NADCs, which include cancers such as prostate, liver, anal, breast, colon, and Hodgkin’s lymphoma. These cancers, once rare in PWH, are becoming more common, yet their relationship to HIV, immunosuppression, and behavioral health factors remains poorly understood. Our study seeks to identify how high-risk behaviors—particularly tobacco and alcohol use—impact the development and progression of these cancers.

Study Goals and Objectives

The primary objective of our research is to examine the links between HIV status, high-risk behaviors, and the incidence of NADCs. By leveraging large-scale datasets, including from the All of Us Research Program, we aim to develop a clearer picture of how behavioral factors like smoking and alcohol consumption, alongside social determinants such as access to care and socioeconomic status, influence cancer risk and outcomes in PWH. Specifically, our study focuses on two cohorts: PWH with one or more NADC diagnoses and those without any NADC, exploring how lifestyle and behavioral factors differ between these groups.

The Role of Behavioral Health in Cancer Risk

There is evidence to suggest that PWH are more likely to engage in behaviors such as smoking and excessive alcohol use, both of which are established risk factors for a range of cancers. Our study seeks to go beyond these general findings by exploring systemic and social determinants that might contribute to these health-risk behaviors (e.g., minority stress, stigma, self-worth) and identifying differences in tobacco and alcohol use patterns between PWH with and without NADCs. Early data suggest that higher rates of tobacco use may partly explain the increased cancer burden in this population, while alcohol use has been linked to both increased cancer risk and complicating treatment outcomes.

Implications for Treatment and Prevention

Understanding the relationship between HIV, cancer, and high-risk behaviors could lead to more tailored interventions to reduce the incidence and improve the treatment of NADCs in PWH. By identifying key behavioral and social risk factors, we hope to inform the development of targeted prevention strategies, particularly around smoking cessation and alcohol use reduction, to help mitigate the growing cancer burden in this vulnerable population.

Looking Ahead

As we continue this vital work, we are committed to sharing our findings with the scientific community, healthcare providers, and the general public. At IBHRI, we believe that collaboration and innovation are key to solving complex public health challenges, and this study represents a significant step toward improving the health and well-being of PWH facing the dual challenges of HIV and cancer. Stay tuned for updates as our research progresses.

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The Research Team

Anthony Pulford, Research Affiliate (Bio)
Aldo Juarez, Research Affiliate (Bio)
Alexis Galano, Research Intern (Bio)