The Confluence of Cancer Stigma and HIV Stigma in HIV-positive Individuals Diagnosed with Cancer (R21 Clinical Trial Optional)

The National Cancer Institute (NCI) has issued a funding opportunity announcement (FOA), RFA-CA-25-012, titled “The Confluence of Cancer Stigma and HIV Stigma in HIV-positive Individuals Diagnosed with Cancer.” This R21 exploratory grant seeks to support pilot studies that examine the combined effects of HIV-related and cancer-related stigma on health outcomes in people with HIV (PWH) who have been diagnosed with cancer. Specifically, the grant encourages research into how these converging stigmas impact patient experience and cancer outcomes, along with ways to mitigate these stigmas through multi-level interventions that target modifiable mechanisms. Research can be domestic or international, with emphasis on regions where HIV and cancer burdens are particularly high. The FOA emphasizes understanding the compounded stigma experience, as research has shown that HIV and cancer stigmas do not simply add up but interact to produce unique health and psychosocial outcomes. Negative outcomes related to dual stigmas might include delays in healthcare access, reduced adherence to treatment, poor communication with healthcare providers, and decreased engagement in supportive services. Research areas of interest include but are not limited to: developing measurement tools for assessing stigma mechanisms, exploring the effects of stigma on patient resilience and social support, reducing stigma in behavioral risk factors (e.g., tobacco use), and investigating the role of media and policy in stigma perpetuation or reduction. Applications must include both HIV and cancer-related measures, and proposals involving intervention studies must address stigma at multiple levels. Eligible applicants include public and private higher education institutions, nonprofits, for-profits, various levels of government, and non-U.S. entities. Researchers are encouraged to engage stakeholders from the HIV-cancer community, such as patients, caregivers, healthcare providers, and community organizations. Applications must also demonstrate sensitivity to social, cultural, and economic factors that may intersect with HIV and cancer stigma, especially as they relate to race, gender, and socioeconomic status. Priority is given to adult PWH, and projects should align with high-priority research areas defined in NIH HIV/AIDS guidelines. The FOA has a total budget of $1 million for FY 2025, with up to three awards anticipated. Funding requests for R21 applications are limited to $275,000 in direct costs across a two-year period, with no more than $200,000 permitted in any single year. The submission deadline is December 10, 2024, with applications encouraged to be submitted early to allow time for corrections. A pre-application webinar is scheduled to provide further guidance to applicants. Review criteria will assess the significance of the project in addressing HIV and cancer stigma and its impact on health outcomes, innovation in research approach, methodological rigor, and feasibility. Projects are also evaluated on the relevance of the investigative team’s expertise in social, behavioral, and cultural dynamics as they pertain to the proposed research setting. Successful applicants will be expected to attend an investigators' meeting during Year 2 of the award, fostering collaboration and knowledge sharing. Applicants proposing clinical trials may reference the NIH Research Methods Resources website for further guidance on study design and statistical methods. In summary, this FOA supports exploratory research into the intersection of HIV and cancer stigma, focusing on the development of strategies and interventions to improve health outcomes for PWH diagnosed with cancer. By addressing stigma in healthcare settings, media, and policy, the program aims to enhance understanding and support for this population across diverse sociocultural contexts.