Management of HIV-Associated Cancers in Sub-Saharan Africa: A Scoping Review of Treatment Outcomes, Challenges, and Strategies for Enhancing Care

Background: People living with HIV in sub-Saharan Africa face a growing burden of cancer, yet evidence on treatment outcomes and barriers to care is dispersed across cancer types and settings. This review examined treatment approaches, outcomes, challenges, and strategies for improving care. Methods: We conducted a scoping review of primary studies identified through searches of MEDLINE via PubMed, CINAHL, EBSCO, Google Scholar, and African Journals Online, with ClinicalTrials.gov searched for relevant interventional studies. Data on cancer treatment, outcomes, HIV care, barriers, and service strategies were charted and synthesised descriptively. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) tools to inform interpretation. Results: Thus, 51 reports from ten countries were included: 13 on Kaposi sarcoma, 13 on cervical cancer, 11 on lymphoma, 8 on breast cancer, and 6 on other cancers or mixed-cancer populations. Selected treatment cohorts reported tumour responses and survival after chemotherapy, radiotherapy, surgery, or combined treatment. Across the care pathway, however, delayed diagnosis, limited treatment capacity, travel and financial costs, toxicity, interrupted treatment, and loss to follow-up constrained outcomes. Associations between HIV status and survival varied by cancer and setting. HIV-specific outcomes were reported inconsistently, and pooled outcomes from studies combining participants with and without HIV could not be attributed to people with HIV alone. Care coordination and patient support were frequently proposed, but few strategies were evaluated comparatively. Conclusions: Improving outcomes requires timely access to complete cancer treatment, coordinated HIV and oncology care, and support for patients throughout treatment. Studies beginning at diagnosis and comparative evaluations of service interventions are needed to establish which approaches improve treatment completion and survival. The study protocol was registered prospectively on the Open Science Framework: 10.17605/OSF.IO/8642R.