The prevalence of cigarette smoking among HIV+ individuals is greater than that found in the general population. However, factors related to smoking within this population are not well understood. This study examined the associations between smoking and demographic, medical, substance use, and psychosocial factors in a clinic-based sample of HIV+ men and women. Two hundred twelve participants completed self-report measures of tobacco use, HIV-related symptoms, viral load, CD4, alcohol and illicit drug use, depression, and social support. Multinomial logistic regression analyses modeled the independent associations of the cross-sectional set of predictors with smoking status. Results indicated that 74% of the sample smoked at least one cigarette per day; using standard definitions, 23% of the sample were light smokers, 22% were moderate smokers, and 29% smoked heavily. Smoking was associated with more HIV-related symptoms, greater alcohol and marijuana use, and less social support. Light smoking was related to minority race/ethnicity and less income; moderate smoking was associated with less education; and heavy smoking was related to less education and younger age. Viral load, CD4 count, and depression were not associated with smoking status. Psychosocial interventions targeting this population should consider the relationships between biopsychosocial factors and smoking behavior.
High Smoking Prevalence among HIV+ Men and Women: Examining Health, Substance Use, and Psychosocial Correlates across the Smoking SpectrumSmoking is highly prevalent among persons living with HIV and may contribute to premature morbidity and mortality. Among HIV+ individuals, prevalence rates of smoking range from 50% to 70% (Burkhalter et al., 2005;Miguez-Burbano et al., 2005;Niaura et al., 2000) compared to 21% for the general population (CDC, 2005). Smoking is strongly associated with two of the primary causes of illness and death in HIV+ patients: community-acquired pneumonia (CAP) and Pneumocystis jiroveci pneumonia (formerly known as Pneumocystis ciroveci; Arcavi & Benowitz, 2004;Miguez-Burbano et al., 2005). HIV+ smokers are also at increased risk for oral lesions (Palacio et al., 1997) Beck & Slade, 1996), and AIDS-related spontaneous pneumothorax (Metersky et al., 1995).Young smokers infected with HIV may be particularly vulnerable to malignant tumors, such as lung cancer (Patel et al., 2006;Spano et al., 2004). Moreover, smoking by HIV+ patients may facilitate the progression to Acquired Immune Deficiency Syndrome (AIDS) (Neiman et al., 1993).Evidence also suggests that smoking has adverse effects on the health-related quality of life (HRQL) of HIV+ men and women. Vidrine et al. (2006) tested a framework for HRQL of life among HIV+ individuals. They found that HRQL is influenced by relationships among physical symptoms, and cognitive, psychological, and social functioning (Brenner et al., 1995;Wilson & Cleary, 1995). They also found that smoking, alcohol use, and SES impair overall HRQL. Other work has also found rel...