In East and Southern Africa, people with HIV (PWH) experience worse cancer-related outcomes and are at higher risk of developing certain cancers. Siloed care delivery pathways pose a substantial barrier to co-management of HIV and cancer care delivery. We conducted cross-sectional studies of adult cancer patients at public radiotherapy and oncology units in Malawi (Kamuzu Central Hospital), Zimbabwe (Parirenyatwa Group of Hospitals), and South Africa (Charlotte Maxeke Hospital) between 2018 and 2019. We abstracted cancer- and HIV-related data from new cancer patient records and used Poisson regression with robust variance to identify patient characteristics associated with HIV documentation. We included 1,648 records from Malawi (median age 46 years), 1,044 records from South Africa (median age 55 years), and 1,135 records from Zimbabwe (median age 52 years). Records from all three sites were predominately from female patients; the most common cancers were cervical (Malawi [29%] and Zimbabwe [43%]) and breast (South Africa [87%]). HIV status was documented in 22% of cancer records from Malawi, 92% from South Africa, and 86% from Zimbabwe. Patients with infection-related cancers were more likely to have HIV status documented in Malawi (adjusted prevalence ratio [aPR]: 1.92, 95% confidence interval [CI]: 1.56–2.38) and Zimbabwe (aPR: 1.16, 95%CI: 1.10–1.22). Patients aged ≥ 60 years were less likely to have HIV status documented (Malawi: aPR: 0.66, 95% CI: 0.50–0.87; Zimbabwe: aPR: 0.76, 95%CI: 0.72–0.81) than patients under age 40 years. Patient age and cancer type were not associated with HIV status documentation in South Africa. Different cancer centers have different gaps in HIV status documentation and will require tailored strategies to improve processes for ascertaining and recording HIV-related information in cancer records. Further research by our consortium to identify opportunities for integrating HIV and cancer care delivery is underway.

中文翻译：

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马拉维、津巴布韦和南非区域癌症中心癌症患者的艾滋病毒状况记录

在东部和南部非洲，艾滋病毒感染者 (PWH) 的癌症相关结果更差，并且患某些癌症的风险更高。孤立的护理提供途径对艾滋病毒和癌症护理的共同管理构成了巨大障碍。我们于 2018 年至 2019 年间对马拉维（卡穆祖中央医院）、津巴布韦（Parirenyatwa 医院集团）和南非（夏洛特马克塞克医院）的公共放射治疗和肿瘤科的成年癌症患者进行了横断面研究。来自新癌症患者记录的 HIV 相关数据，并使用具有稳健方差的泊松回归来识别与 HIV 记录相关的患者特征。我们纳入了来自马拉维的 1,648 条记录（中位年龄 46 岁）、来自南非的 1,044 条记录（中位年龄 55 岁）和来自津巴布韦的 1,135 条记录（中位年龄 52 岁）。所有三个站点的记录主要来自女性患者；最常见的癌症是宫颈癌（马拉维[29%]和津巴布韦[43%]）和乳腺癌（南非[87%]）。马拉维 22%、南非 92% 和津巴布韦 86% 的癌症记录中记录了艾滋病毒状况。在马拉维（调整后患病率 [aPR]：1.92，95% 置信区间 [CI]：1.56–2.38）和津巴布韦（aPR：1.16，95%CI：1.10），患有感染相关癌症的患者更有可能记录有 HIV 状态–1.22）。与 40 岁以下的患者相比，年龄 ≥ 60 岁的患者记录 HIV 状况的可能性较小（马拉维：aPR：0.66，95% CI：0.50–0.87；津巴布韦：aPR：0.76，95% CI：0.72–0.81）。在南非，患者年龄和癌症类型与艾滋病毒状况记录无关。不同的癌症中心在艾滋病毒状况记录方面存在不同的差距，需要量身定制的策略来改进在癌症记录中确定和记录艾滋病毒相关信息的流程。我们的联盟正在进行进一步研究，以确定整合艾滋病毒和癌症护理服务的机会。