The Unique Challenges Facing HIV-Positive Patients Who Smoke Cigarettes: HIV Viremia, Art Adherence, Engagement in HIV care, and Concurrent Substance Use

O’Cleirigh, Conall; Valentine, Sarah E.; Pinkston, Megan; Herman, Debra S.; Bedoya, C. Andres; Gordon, Janna R.; Safren, Steven A.

doi:10.1007/s10461-014-0762-7

Cited by 81 publications

(66 citation statements)

References 46 publications

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“…Consistent with this, one study of infectious disease clinic patients found through mediational analyses that lower levels of self-reported adherence in smokers might be due to smokers having higher levels of depressive symptoms (24). Similarly, O’Cleirigh et al (22) found that smoking was not only related to non-adherence but that smokers were more likely than non-smokers to endorse problematic alcohol, cocaine, heroin, and marijuana use. On the other hand, Shuter and Bernstein (25) found that current cigarette smoking was a predictor of non-adherence to ART among HIV+ men and women, independent of factors such as drug use history, history of psychiatric illness, and current depression ( n = 64).…”

Section: Introductionmentioning

confidence: 97%

“…Research indicates that many factors are related to adherence including covariates of race, such as discrimination (12, 13), psychiatric diagnoses (14,15) such as depression, alcohol or other drug use (16–18), stress (18,19), social support (20) and coping styles (21). However, there is emerging literature suggesting that tobacco smoking, which is highly prevalent among HIV+ individuals, may also be associated with poor ART adherence (22–26). An estimated 47–70% of people living with HIV/AIDS (PLWHA) smoke cigarettes (24,27,28) and smokers have been shown to be less adherent to a variety of medications (29).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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Smoking is highly prevalent among HIV+ individuals and studies indicate that it may be associated with poor ART adherence, though the relationship is poorly understood. In addition little is known about interest in quitting among HIV+ smokers who are having adherence difficulties. We examined smoking and ART adherence among 203 HIV+ individuals enrolled in a randomized trial of interventions to increase ART adherence. Prior analyses indicated there were no overall treatment group effects. Smoking status and motivation to quit was assessed at baseline and ART adherence was assessed at week 12, 24, 36, and 48. Longitudinal generalized estimating equation analysis that controlled for treatment group revealed that smoking status was not significantly related to adherence over time. Motivation to quit was high with 58% intending to quit in the next 6 months and 25% intending to quit in the next 30 days. Findings suggest that smoking is not associated with adherence among those with adherence difficulties. However it does not diminish importance of addressing both behaviors especially given HIV+ smokers substantial interest in changing smoking behavior.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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“…37 Our definition of smoking control in the current study did not take into account long-term cessation, and almost half of the women who recently quit smoking reported a smoking relapse 6 months later (data not shown). Given the substantial health benefits associated with quitting smoking, targeted interventions for HIV-infected women, potentially integrated with other behavioral interventions addressing substance use, 38 should be considered to improve cessation.…”

Section: Discussionmentioning

confidence: 99%

Trends in Nonlipid Cardiovascular Disease Risk Factor Management in the Women's Interagency HIV Study and Association with Adherence to Antiretroviral Therapy

Hanna

Jung

Xue

et al. 2016

AIDS Patient Care and STDs

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Cardiovascular disease (CVD) is increasingly common among women with HIV, but literature on nonlipid CVD risk factor management is lacking. We examined semiannual trends from 2006 to 2014 in hypertension treatment and control (blood pressure <140/90 mmHg), diabetes treatment and control (fasting glucose <130 mg/dL), and smoking quit rates in the Women's Interagency HIV Study. Unadjusted and adjusted Poisson regression models tested time trends and differences between HIV+ and HIV-women. Among antiretroviral therapy (ART) users, we examined the association of ART adherence and virologic suppression with each outcome. We evaluated 1636 HIV+ and 683 HIV-women, with a hypertension prevalence of 40% and 38%, respectively; diabetes prevalence of 21% and 22%; and smoking prevalence of 37% and 48%. Hypertension treatment was higher among HIV+ than HIV-women (77% vs. 67%, p < 0.001) and increased over time with no difference in trend by HIV status. Hypertension control was greater among HIV+ women (56% vs. 43%, p < 0.001) and increased over time among HIV+ but not HIV-women. Diabetes treatment was similar among HIV+ and HIV-women (48% vs. 49%) and increased over time in both groups. Diabetes control was greater among HIV+ women (73% vs. 64%, p = 0.03) and did not change over time. The percent of recent smokers who reported no longer smoking was similar between HIV+ and HIV-women (10% vs. 9%), with no differences over time. Virologic suppression was significantly associated with increased hypertension treatment and greater control. HIV+ women have better control of hypertension and diabetes than HIV-women, but many are still not at target levels.

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“…Because substances use were measured with an index that puts emphasis on his use in the lapse of the last 30 days, these behaviors must be understood as a variable of contextual nature, interacting with other of accumulative nature and continually modifiable, e.g., behavioral competencies and motives. Thus, from a psychological perspective it is necessary to consider in the analysis the factors of the psychological history -e.g., personality, motives and past behavioral competencies -and those of the present context, to predict and understand why HIV+ persons consistently and efficiently practicing or not medication-adherence behaviors [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Behavioral Competencies and Low Alcohol and Drugs Use Predicts Medication - Adherence Behaviors Among HIV+ Persons from Venezuela

JA¹,

Ávila²,

EM³

et al. 2016

IJHR

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BackgroundThe success of the antiretroviral therapy (ART) among HIV+ persons strongly rely on individual factors, including the patient's personality characteristics [1,2], a good motivation and a set of knowledge, skills and abilities related to both the disease and treatment [3], the concurrence of adaptative emotional states [4], and a low alcohol and drugs use [5,6]. Despite convergent body of evidence has confirmed the role of individual factors on medication-adherence behaviors in Latin America countries and the Caribbean region, such as Argentina [7], Chile [8], Peru [9] and the Dominican Republic [10], little progress has been made in countries like Venezuela. In fact, only two studies using HIV+ samples have been found, in both cases putting emphasis in the influence of socio-demographic and clinical patient's characteristics on medication-adherence behaviors [11,12].Considering those antecedents and the need to investigate the influence of individual factors on medication-adherence behaviors in Venezuelan HIV+ persons, this study was justified in a psychological model for the research of adherence behaviors (PMAB) in persons living with chronic diseases, including HIV infection [13]. As show in Figure 1, the model emphasizes the interaction of psychological and biological variables along four phases. The first involves psychological process variables related to personality, motives and behavioral competencies; the second involves the HIV diagnosis and other co-morbidities; the third involves two types of behaviors: medication-adherence behaviors and disease-related behaviors -e.g., impulsivity, anger, depression, social isolation, etc.; the fourth involves biological measures and Methods: We conducted a cross-sectional study of 124 HIV+ persons recruited in an outpatient clinic in the state of Lara, Venezuela, who completed a self-administered questionnaire measuring psychological variables and medication-adherence behaviors, as well as an index of alcohol and drugs use. Moment-product correlation and structural equation modeling were applied for data analyses. Results: Current behavioral competencies showed a direct effect on medication-adherence behaviors, mediating the indirect effect of low alcohol and drugs use. The structural equation modeling demonstrated a good fit to the sample data: χ

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The Unique Challenges Facing HIV-Positive Patients Who Smoke Cigarettes: HIV Viremia, Art Adherence, Engagement in HIV care, and Concurrent Substance Use

Cited by 81 publications

References 46 publications

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

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

Trends in Nonlipid Cardiovascular Disease Risk Factor Management in the Women's Interagency HIV Study and Association with Adherence to Antiretroviral Therapy

Behavioral Competencies and Low Alcohol and Drugs Use Predicts Medication - Adherence Behaviors Among HIV+ Persons from Venezuela

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