The Relationship Between ART Adherence and Smoking Status Among HIV+ Individuals

Moreno, J.L.; Catley, Delwyn; Lee, Hyoung; Goggin, Kathy

doi:10.1007/s10461-014-0978-6

Cited by 13 publications

(10 citation statements)

References 48 publications

(48 reference statements)

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“…However, in multivariable models after adjusting for covariates, no significant associations were found between current smoking and imperfect ART adherence. Others (21, 22) have examined medication adherence and smoking in PLWH, and also have not found an association with ART adherence. It is possible that smoking and imperfect ART adherence share similar risk factors and, perhaps, smoking may be acting as a surrogate marker for these other factors.…”

Section: Discussionmentioning

confidence: 99%

“…While some studies have shown that smokers have a higher prevalence of detectable HIV viral load (14, 18–20), overall, research in this area has provided mixed results with regard to the association between cigarette smoking and ART adherence. For example, two studies found no association between smoking status and ART adherence (21, 22), while another found that nicotine dependence (measured by the Fagerstrom Test for Nicotine Dependence [FTND]) was significantly related to suboptimal adherence (23). Thus, there remain open questions about the associations between smoking and HIV medication adherence.…”

Section: Introductionmentioning

confidence: 99%

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Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM)

et al. 2016

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Cigarette smoking and heavy alcohol use is prevalent among HIV-infected men who sex with men (MSM) and have been linked to imperfect antiretroviral therapy (ART) adherence. Our study examined the correlates of smoking and whether smoking was independently associated with imperfect adherence in heavy-drinking HIV-infected MSM. Of the 185 participants, approximately half (n = 91, 49.2%) reported having smoked cigarettes in the past 30 days. Current smokers were more likely to have reported imperfect adherence compared to non-smokers (37.4.2% vs. 22.3%, p < 0.05). In multivariable regression analyses, only lower education was significantly associated with imperfect adherence. This study demonstrated that the greatest risk factor for smoking and imperfect ART adherence was low socioeconomic status, in which MSM of color were over-represented. As the first study to examine smoking and ART adherence in this population, our study has the potential to inform the clinical care provided to heavy-drinking MSM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM)

et al. 2016

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“…This increased susceptibility has been mainly attributed to biochemical mechanisms including the immunosuppressive effects of smoking and its negative impact on immune and virological response even when on ART 13 . Behavioural mechanisms have also been suggested—for example, an association between smoking and non-adherence to antiretroviral therapy 14, 15…”

Section: Introductionmentioning

confidence: 99%

Tobacco use among people living with HIV: analysis of data from Demographic and Health Surveys from 28 low-income and middle-income countries

Mdege

Shah

Ayo‐Yusuf

et al. 2017

The Lancet Global Health

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SummaryBackgroundTobacco use among people living with HIV results in excess morbidity and mortality. However, very little is known about the extent of tobacco use among people living with HIV in low-income and middle-income countries (LMICs). We assessed the prevalence of tobacco use among people living with HIV in LMICs.MethodsWe used Demographic and Health Survey data collected between 2003 and 2014 from 28 LMICs where both tobacco use and HIV test data were made publicly available. We estimated the country-specific, regional, and overall prevalence of current tobacco use (smoked, smokeless, and any tobacco use) among 6729 HIV-positive men from 27 LMICs (aged 15–59 years) and 11 495 HIV-positive women from 28 LMICs (aged 15–49 years), and compared them with those in 193 763 HIV-negative men and 222 808 HIV-negative women, respectively. We estimated prevalence separately for males and females as a proportion, and the analysis accounted for sampling weights, clustering, and stratification in the sampling design. We computed pooled regional and overall prevalence estimates through meta-analysis with the application of a random-effects model. We computed country, regional, and overall relative prevalence ratios for tobacco smoking, smokeless tobacco use, and any tobacco use separately for males and females to study differences in prevalence rates between HIV-positive and HIV-negative individuals.FindingsThe overall prevalence among HIV-positive men was 24·4% (95% CI 21·1–27·8) for tobacco smoking, 3·4% (1·8–5·6) for smokeless tobacco use, and 27·1% (22·8–31·7) for any tobacco use. We found a higher prevalence in HIV-positive men of any tobacco use (risk ratio [RR] 1·41 [95% CI 1·26–1·57]) and tobacco smoking (1·46 [1·30–1·65]) than in HIV-negative men (both p<0·0001). The difference in smokeless tobacco use prevalence between HIV-positive and HIV-negative men was not significant (1·26 [1·00–1·58]; p=0·050). The overall prevalence among HIV-positive women was 1·3% (95% CI 0·8–1·9) for tobacco smoking, 2·1% (1·1–3·4) for smokeless tobacco use, and 3·6% (95% CI 2·3–5·2) for any tobacco use. We found a higher prevalence in HIV-positive women of any tobacco use (RR 1·36 [95% CI 1·10–1·69]; p=0·0050), tobacco smoking (1·90 [1·38–2·62]; p<0·0001), and smokeless tobacco use (1·32 [1·03–1·69]; p=0·030) than in HIV-negative women.InterpretationThe high prevalence of tobacco use in people living with HIV in LMICs mandates targeted policy, practice, and research action to promote tobacco cessation and to improve the health outcomes in this population.FundingSouth African Medical Research Council and the UK Medical Research Council.

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“…Furthermore, patients who are co-infected with TB and HIV, and who smoke, are predisposed to many HIV-related complications [9]. In addition tobacco smoking and alcohol consumption are associated with reduced ART initiation and adherence [10,11], which also negatively influences clinical response to treatment.…”

Section: Introductionmentioning

confidence: 99%

Addressing tobacco smoking and drinking to improve TB treatment outcomes, in South Africa: a feasibility study of the ProLife program

Louwagie

Morojele

Siddiqi

et al. 2019

Translational Behavioral Medicine

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Alcohol and tobacco use may lead to negative treatment outcomes in tuberculosis (TB) patients, and even more so if they are HIV-infected. We developed and tested the feasibility of a complex behavioral intervention (ProLife) delivered by lay health workers (LHWs) to improve treatment outcomes in TB patients who smoke tobacco and/or drink alcohol, at nine clinics in South Africa. The intervention comprised three brief motivational interviewing (MI) sessions augmented with a short message service (SMS) program, targeting as appropriate: tobacco smoking, harmful or hazardous drinking and medication adherence. Patients received SMSs twice a week. We measured recruitment and retention rates and assessed fidelity to the MI technique (MI Treatment Integrity 4.1 tool). Finally, we explored LHWs’ and patients’ experiences through interviews and semi-structured questionnaires, respectively. We screened 137 TB patients and identified 14 smokers, 13 alcohol drinkers, and 18 patients with both behaviors. Participants’ mean age was 39.8 years, and 82.2% were men. The fidelity assessments pointed to the LHWs’ successful application of key MI skills, but failure to reach MI competency thresholds. Nevertheless, most patients rated the MI sessions as helpful, ascribed positive attributes to their counselors, and reported behavioral changes. SMSs were perceived as reinforcing but difficult language and technical delivery problems were identified as problems. The LHWs’ interview responses suggested that they (a) grasped the basic MI spirit but failed to understand specific MI techniques due to insufficient training practice; (b) perceived ProLife as having benefitted the patients (as well as themselves); (c) viewed the SMSs favorably; but (d) considered limited space and privacy at the clinics as key challenges. The ProLife program targeting multiple risk behaviors in TB patients is acceptable but LHW training protocol, and changes in wording and delivery of SMS are necessary to improve the intervention. Trial registration: ISRCTN14213432

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The Relationship Between ART Adherence and Smoking Status Among HIV+ Individuals

Cited by 13 publications

References 48 publications

Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM)

Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM)

Tobacco use among people living with HIV: analysis of data from Demographic and Health Surveys from 28 low-income and middle-income countries

Addressing tobacco smoking and drinking to improve TB treatment outcomes, in South Africa: a feasibility study of the ProLife program

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