Evidence map›Paper›PMID 35794634›Full record

ArticleInfectious agents and cancer2022

Barriers and facilitators to chemotherapy initiation and adherence for patients with HIV-associated Kaposi's sarcoma in Kenya: a qualitative study.

Devon E McMahon, Rhea Singh, Linda Chemtai, Aggrey Semeere, Helen Byakwaga, Merridy Grant, Miriam Laker-Oketta, Celestine Lagat, Sigrid Collier, Toby Maurer and 6 more

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Article in Infectious agents and cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Factors, including patient education, that impact cancer treatment adherence in low- and middle-income African countries: a scoping review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Devon E McMahon *Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, 50 Staniford St, Boston, MA, 02114, USA.
Rhea Singh *Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, 50 Staniford St, Boston, MA, 02114, USA.
Linda ChemtaiAMPATH, Moi University, Eldoret, Kenya.
Aggrey SemeereInfectious Disease Institute, Kampala, Uganda.
Helen ByakwagaInfectious Disease Institute, Kampala, Uganda.
Merridy GrantUniversity of KwaZulu-Natal, Durban, South Africa.
Miriam Laker-OkettaInfectious Disease Institute, Kampala, Uganda.
Celestine LagatAMPATH, Moi University, Eldoret, Kenya.
Sigrid CollierUniversity of Washington, Seattle, WA, USA.
Toby MaurerIndiana University, Indianapolis, IN, USA.
Jeffrey MartinUniversity of California San Francisco, San Francisco, CA, USA.
Ingrid V BassettDepartment of Dermatology, Harvard Medical School, Massachusetts General Hospital, 50 Staniford St, Boston, MA, 02114, USA.
Lisa ButlerUniversity of Connecticut, Storrs, CT, USA.
Samson KipronoAMPATH, Moi University, Eldoret, Kenya.
Naftali BusakhalaAMPATH, Moi University, Eldoret, Kenya.
Esther E FreemanDepartment of Dermatology, Harvard Medical School, Massachusetts General Hospital, 50 Staniford St, Boston, MA, 02114, USA. efreeman@mgh.harvard.edu.

Funding

United States-East Africa HIV-Associated Malignancy Research Center (USEAHAMRC) for Career Development and the Prevention, Early Detection and Efficient Linkage to Care for Virus-related CancersU54CA254571 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MARTIN, JEFFREY N · 2020 to 2025
$5.6M
Why do Patients Develop KSU54CA190153 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KAMBUGU, ANDREW DDUNGU, MARTIN, JEFFREY N · 2014 to 2019
$3.6M
Mentoring in patient-oriented research on HIV prevention in the US and South AfricaK24AI141036 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI Ingrid Valerie Bassett · 2019 to 2026
$1.1M
Improving the Care Cascade for HIV-associated Kaposi's Sarcoma in sub-Saharan AfricaK23AI136579 · NIAID · MASSACHUSETTS GENERAL HOSPITAL · PI FREEMAN, ESTHER E · 2018 to 2022
$1.1M
National Institute of Allergy and Infectious Diseases K23AI136579National Institute of Allergy and Infectious Diseases K24AI141036NCI NIH HHS U54 CA190153NCI NIH HHS U54CA190153NCI NIH HHS U54 CA254571NCI NIH HHS U54CA254571NIAID NIH HHS K23 AI136579NIAID NIH HHS K24 AI141036
6 · The paper itself

Abstract

backgroundKaposi sarcoma is one of the most prevalent HIV-associated malignancies in sub-Saharan Africa and is often diagnosed at advanced stage of disease. Only 50% of KS patients who qualify for chemotherapy receive it and adherence is sub-optimal.

methods57 patients > 18 years with newly diagnosed KS within the AMPATH clinic network in Western Kenya were purposively selected to participate in semi-structured interviews stratified by whether they had completed, partially completed, or not completed chemotherapy for advanced stage KS. We based the interview guide and coding framework on the situated Information, Motivation, Behavioral Skills (sIMB) framework, in which the core patient centered IMB constructs are situated into the socioecological context of receiving care.

resultsOf the 57 participants, the median age was 37 (IQR 32-41) and the majority were male (68%). Notable barriers to chemotherapy initiation and adherence included lack of financial means, difficulty with convenience of appointments such as distance to facility, appointment times, long lines, limited appointments, intrapersonal barriers such as fear or hopelessness, and lack of proper or sufficient information about chemotherapy. Factors that facilitated chemotherapy initiation and adherence included health literacy, motivation to treat symptoms, improvement on chemotherapy, prioritization of self-care, resilience while experiencing side effects, ability to carry out behavioral skills, obtaining national health insurance, and free chemotherapy.

conclusionOur findings about the barriers and facilitators to chemotherapy initiation and adherence for KS in Western Kenya support further work that promotes public health campaigns with reliable cancer and chemotherapy information, improves education about the chemotherapy process and side effects, increases oncology service ability, supports enrollment in national health insurance, and increases incorporation of chronic disease care into existing HIV treatment networks.

Indexed as

AdherenceAfrica South of the SaharaChemotherapyHIV/AIDSKaposi sarcomaKenyaQualitativeTreatment

Identifiers

PMID35794634
PMCPMC9258164

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