Cancer Awareness Among People Living with HIV (PLWH): Insights from an Italian Survey of Oncologists and Infectious Disease Specialists

Davide Dalu,1 Rosaria Iardino,2 Emanuela Vaccher,3 Angioletta Lasagna,4 Margherita Digaetano,5 Alberto Giovanni Leone,6 Lorenzo Ruggieri,1 Eva Massari,2 Eva Blondeaux,7 Andrea Gori,8,9 Cristina Mussini,10 Giuliano Rizzardini,9 Matteo Bassetti,11,12 Antonio Di Biagio,11 Claudio M Mastroianni,13 Luisa Brogonzoli,2 Mario Cascio,14 Francesco Perrone,15 Saverio Cinieri,16 Giordano D Beretta,17 Nicla La Verde1 1Department of Oncology, Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; 2The Bridge Foundation, Milan, Italy; 3Infectious Diseases and Tumors Unit, Department of Medical Oncology, Centro Di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, Aviano, Italy; 4Department of Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 5Clinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy; 6Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy; 7Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; 8Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy; 9Department of Infectious Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; 10Division of Infectious Diseases, University of Modena, Modena, Italy; 11Clinic of Infectious Diseases, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy; 12Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy; 13Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; 14European AIDS Treatment Group (EATG), Brussels, Belgium; 15Clinical Trial Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G Pascale, Naples, Italy; 16Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, Italy; 17Medical Oncology, Santo Spirito Hospital, Pescara, ItalyCorrespondence: Lorenzo Ruggieri, Department of Medical Oncology, Luigi Sacco University Hospital - ASST Fatebenefratelli Sacco, Via G.B. Grassi, 74, Milan, 20157, Italy, Tel +39-0239042492, Email [email protected]: Since the mid-1990s, the adoption of combined antiretroviral therapy (cART) has significantly reduced HIV-related mortality and morbidity. Nevertheless, cancer continues to be the leading cause of death in people living with HIV (PLWH). We conducted a survey to assess the knowledge and inter-disciplinarity among the Italian oncologists and infectious disease specialists in the cancer prevention and treatment of PLWH.Materials and Methods: All the members of AIOM, SIMIT and SITA who are oncologists and infectious disease specialists were invited via email. A survey with 24 queries was administered using a web-based platform. Data were analysed with the chi-square or Fisher exact tests to explore any significant difference between the two specialist subgroups.Results: From April to June 2023, 182 participants filled in the questionnaires. A low rate of respondents from each scientific society was reported (3% for AIOM, 8% from SIMIT and 2% from SITA). All interviewees agreed that HIV infection was a relevant risk factor for cancer (95.1%) and that PLWH had limited access to clinical trials (73.1%). More than a third of oncologists worked in a hospital without an infectious diseases department, using a remote method of communication for interdisciplinary discussion (telephone and Email were used in 64.5% of cases). Eighty-four percent of the oncologists vs 51.4% of the infectious disease specialists had in charge less than 5 patients with HIV during the previous year.Conclusion: The results of this survey underscore the opportunity for education, interdisciplinary collaboration, and organizational support to optimize cancer care for PLWH. A Hub&Spoke model could represent a potential facilitation to build-up in the near future through inter-societal collaboration.Plain language summary: In the last years, antiretroviral therapy consistently prolonged the life expectancy of people living with HIV (PLWH).To date, cancer remains a leading cause of death for PLWH.We conducted a web-based survey directed to oncologists and infectious disease specialists.The survey underscored a reduced specialist awareness regarding the main needs of patients with HIV and cancer.Keywords: HIV, cancer, PLWH, survey, Italy, chemotherapy