Tobacco smoking is associated with adverse health effects among people living with HIV (PLWH), including a higher risk of cancer and cardiovascular problems. Further, there is evidence that PLWH are two to three times more likely to smoke than the general population. The aim of this study was to examine the association between tobacco smoking and biomarkers of HIV disease progression, including unsuppressed viral load (viral load >200 copies/mL) and low CD4 cell count (<200 cells/mm3). Recent tobacco smoking was reported by 40 % (n = 5942) of 14,713 PLWH enrolled in Ryan White Part A programs in the New York City metropolitan area. In multivariate analyses controlling for sociodemographic and clinical characteristics, recent tobacco smoking was independently associated with unsuppressed viral load (AOR = 1.38, CI 1.26–1.50) and low CD4 cell count (AOR = 1.12, CI 1.01–1.24). Findings suggest the importance of routine assessments of tobacco use in clinical care settings for PLWH.

Although there is evidence that peer-led HIV treatment interventions are effective in improving health outcomes of people living with HIV (PLWH), few studies have assessed the health and psychosocial benefits of being a peer living with HIV. Qualitative interviews were conducted with nine PLWH who were peers of an HIV self-management intervention, to examine how this experience was perceived to impact their health behaviors, social support, and professional development. Peers reported improved HIV self-management and reduced health risk behaviors, which were attributed to increased self-efficacy and the desire to be a role model for participants. Peers described the experience as an opportunity to expand social networks and develop professional skills that could be leveraged for future employment. Our findings suggested that the benefits of being a peer could be enhanced in trainings and supervision by linking the importance of health-promoting behaviors to being a role model for other PLWH.

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Participants identified several factors that could be incorporated into an intervention to support HIV-related health-promoting behavior maintenance that could supplement existing HIV self-management interventions.

A community needs assessment was conducted at an AIDS service organization in New York City to inform the development of an HIV and substance abuse prevention program for black and Latino young men who have sex with men (YMSM). Data from the New York City Department of Health and Mental Hygiene indicated that HIV infections in Black andLatino YMSM were concentrated in Brooklyn and Queens. Evidence from existing studies of YMSM suggested that Black and Latino YMSM are more likely than other YMSM to be HIV infected and unaware of their diagnosis. Furthermore, partner characteristics and peer norms might influence HIV infection and HIV sexual risk behavior, particularly among Black YMSM. Recommendations include routine HIV/sexually transmitted infection testing and addressing issues around sexual partners and communication about HIV status and condom use in the context of HIV prevention activities for Black and Latino YMSM.