# Developing measurements to evaluate intersectional stigma related to cancer and HIV

> **NIH NIH U54** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $202,350

## Abstract

PROJECT SUMMARY
 This application is being submitted in response to the Notice of Special Interest (NOSI) identified as
“NOT-CA-23-036.” Sub-Saharan Africa (SSA) bears a disproportional burden of HIV globally. Additionally, the
risk for malignancy in this population far exceeds the general population with higher associated morbidity and
mortality. As the dual burden of HIV and cancer in the global population increases, investigation of the impact
of stigma on this population is crucial for improving health outcomes.
 Stigma is a well-studied construct that occurs when individuals are recognized and labeled as “other”
due to various sociodemographic, behavioral, or health-related characteristics, and has been linked to poor
quality of life and health-related outcomes. Stigma associated with HIV and cancer diagnoses in particular
have been associated to poor mental health, low treatment adherence rates, and decreased healthcare
engagement. When an individual has multiple, co-occurring stigmatizing characteristics, they have the potential
for a more complex stigma experience, termed intersectional stigma. Individuals living with HIV and cancer
may experience stigma more prominently due to one dominant stigmatizing condition or may experience a
synergistic or multiplicative effect. Intersectional stigma has been measured via validated scales for constructs
such as race, ethnicity, gender identity, and behavior, but no scale exists to measure the intersectionality of
HIV and cancer stigma. The ability to measure the stigma experience in people living with HIV and cancer is
crucial for assessing its influence on health-related behaviors and for designing more targeted interventions.
 As an administrative supplement to U54 CA254571, our overall goal is to initiate the development of a
scale that effectively measures intersectional stigma in patients with concurrent HIV and cancer diagnoses.
Our specific aims are: 1) To develop a preliminary pool of scale questions that capture key dimension of HIV
and cancer intersectional stigma. We will use both pre-existing and de-novo qualitative interviews and
quantitative data to develop this initial pool. 2) To involve community stakeholders and participants with HIV
and cancer in further refinement of the pool of scale questions. We will use techniques including member
checking and cognitive debriefing. 3) To complete preliminary item validation on a population subset of patients
living with both HIV and cancer.
 To achieve these aims, we leverage a multidisciplinary team of leaders in stigma, scale development,
HIV-associated cancers, and epidemiology. We will develop an intersectional stigma scale for HIV and cancer
supported by our already existing laboratory for HIV and malignancies in the AMPATH network in western
Kenya, funded by parent grant U54 CA254571. Findings from this work are expected to lead to the
development of an intersectional stigma scale that will help to better characterize co-occuring, pot...

## Key facts

- **NIH application ID:** 10844755
- **Project number:** 3U54CA254571-04S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Andrew Ddungu Kambugu
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $202,350
- **Award type:** 3
- **Project period:** 2020-07-13 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10844755

## Citation

> US National Institutes of Health, RePORTER application 10844755, Developing measurements to evaluate intersectional stigma related to cancer and HIV (3U54CA254571-04S1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10844755. Licensed CC0.

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