# Medicaid data as a complement to cohort studies for investigating cancers among older people with HIV

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $674,794

## Abstract

ABSTRACT
Non-AIDS defining cancers (NADCs) are projected to account for 89% of all cancers among people living with
HIV (PLWH) by 2030, with the vast majority diagnosed among older PLWH. This shift is concerning because,
as compared to people without HIV, PLWH reportedly have higher cancer-specific mortality for several NADCs,
and higher overall mortality after diagnosis of the most common NADCs. The explanation for higher mortality
among PLWH after a NADC is likely multifactorial and, at present, not fully understood. Given approximately
45% of PLWH are 50 years, with 84% of those between 50 and 64, it is critical to understand the intersection
between HIV, NADCs, and healthy aging in this population. To inform the development of effective NADC
prevention and treatment strategies for the aging PLWH population, it is important to be able to disentangle the
influence of HIV from the socio-behavioral factors associated HIV acquisition. To do this, a comparison group
with a comparable burden of risk factors, socioeconomic status, and access to care is needed. Approximately
40% of PLWH in the US are covered by Medicaid. Medicaid beneficiaries are a diverse population, and include
a comparison group for PLWH with similar risk factor burden and access to care. The Medicaid population is
an important complement to existing HIV resources, including those that (1) capture cancer incidence but not
downstream events, such as the HIV-Cancer Match cohort, (2) include rich cohort data, but have limited
specific types of cancer cases to allow for examining race and sex differences, like the NA-ACCORD, and (3)
other claims-based cohorts which capture, important, but different segments of the HIV and general population,
including SEER-Medicare. We propose to assess claims for more than 5 million Medicaid beneficiaries 50
years old from 14 states between 2001 and 2017, in the modern era of antiretroviral therapy, to: (1) quantify
the age-, race/ethnicity-, and sex- specific incidence of NADCs by cancer type among PLWH (2) evaluate the
association between HIV-infection and NADC-specific treatment-related outcomes, (3) evaluate the association
between NADC-specific diagnosis and new AIDS-defining illnesses and retention in HIV care, and (4) evaluate
whether a diagnosis of both HIV and NADC, by cancer type, is associated with a higher risk of age-related
outcomes as compared a diagnosis of HIV or NADC alone. Findings from this study will inform how aging in
the presence of HIV affects the risk and consequences of non-AIDS defining cancers, and impacts HIV care
and age-related outcomes among older adults. Importantly, we will evaluate our aims among a low-income,
diverse population of men and women 50 years old with a comparison population with comparable risk factors
and access to care.

## Key facts

- **NIH application ID:** 10364673
- **Project number:** 5R01CA250851-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Corinne E. Joshu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $674,794
- **Award type:** 5
- **Project period:** 2020-03-24 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10364673

## Citation

> US National Institutes of Health, RePORTER application 10364673, Medicaid data as a complement to cohort studies for investigating cancers among older people with HIV (5R01CA250851-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10364673. Licensed CC0.

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