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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)

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Abstract

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.

Resumen

El uso de tabaco y consumo excesivo de alcohol son prevalentes entre los hombres diagnosticados con HIV quienes tienen relaciones sexuales con otros hombres (HSH), y han sido asociados a la adherencia de terapia antiretroviral (ART) imperfecta. Nuestro estudio examina la correlación entre el acto de fumar y si el fumar es asociado independientemente con la adherencia imperfecta en HSH diagnosticados con HIV, quienes son consumidores excesivos de alcohol. De los 185 participantes del estudio, aproximadamente la mitad (n = 91, 49.2 %) informó haber fumado cigarrillos en los últimos 30 días. Fumadores recurrentes fueron más propensos a reportar adherencia imperfecta en comparación con no fumadores (37.4.2 vs. 22.3 %, p < 0.05). En el análisis de regresión multivariable, solamente baja educación fue significativamente asociada con adherencia imperfecta. Este estudio demostró que el mayor factor de riesgo para fumar y adherencia imperfecta ART fue el bajo estatus socioeconómico, en el cual HSH de color estaban sobrerrepresentados. Siendo el primer estudio en examinar el uso de tabaco y la adherencia ART en esta población, nuestra investigación tiene el potencial de informar preventivamente a la clínica sobre HSH consumidores excesivos de alcohol.

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References

  1. Bangsberg DR, Ragland K, Monk A, Deeks SG. A single tablet regimen is associated with higher adherence and viral suppression than multiple tablet regimens in HIV+ homeless and marginally housed people. AIDS. 2010;24(18):2835–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Gardner EM, Sharma S, Peng G, Hullsiek KH, Burman WJ, MacArthur RD, et al. Differential adherence to combination antiretroviral therapy is associated with virological failure with resistance. AIDS. 2008;22(1):75–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Hogg RS, Heath K, Bangsberg DR, Yip B, Press N, O’Shaughnessy MV, et al. Intermittent use of triple-combination therapy is predictive of mortality at baseline and after 1 year of follow-up. AIDS. 2002;16:1051–8.

    Article  PubMed  Google Scholar 

  4. Cope AB, Powers KA, Kuruc JD, Leone PA, Anderson JA, Ping LH, et al. Ongoing HIV transmission and the HIV care continuum in North Carolina. PLoS One. 2015;10(6):e0127950.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Quinn TC, Wawer MJ, Ewankambo N, Serwadda D, Li C, Wabwire-Mangen F, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. N Engl J Med. 2000;342:921–9.

    Article  CAS  PubMed  Google Scholar 

  6. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Centers for Disease Control and Prevention. Estimated HIV incidence among adults and adolescents in the United States. 2007–2010.http://www.cdc.gov/hiv/topics/surveillance/resources/reports/#supplemental. Accessed Dec 2012.

  8. Hendershot CS, Stoner SA, Pantalone DW, Simoni JM. Alcohol use and antiretroviral adherence: review and meta-analysis. J Acquir Immune Defic Syndr. 2009;52(2):180–202.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Azar MM, Springer SA, Meyer JP, Altice FL. A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug Alcohol Depend. 2010;112(3):178–93.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Malta M, Strathdee SA, Magnanini MM, Bastos FI. Adherence to antiretroviral therapy for human immunodeficiency virus/acquired immune deficiency syndrome among drug users: a systematic review. Addiction. 2008;103(8):1242–57.

    Article  PubMed  Google Scholar 

  11. Rosen MI, Black AC, Arnsten JH, Goggin K, Remien RH, Simoni JM, et al. Association between use of specific drugs and antiretroviral adherence: findings from MACH 14. AIDS Behav. 2013;17(1):142–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Parsons J, Starks TJ, Millar BM, Boonrai K, Marcotte D. Patterns of substance use among HIV-positive adults over 50: implications for treatment and medication adherence. Drug Alcohol Depend. 2014;139:33–40.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Gritz ER, Vidrine DJ, Lazev AB, Amick BC 3rd, Arduino RC. Smoking behavior in a low-income multiethnic HIV/AIDS population. Nicotine Tob Res. 2004;6(1):71–7.

    Article  PubMed  Google Scholar 

  14. Akhtar-Khaleel WZ, Cook RL, Shoptaw S, Surkan P, Stall R, Beyth RJ, et al. Trends and predictors of cigarette smoking among HIV seropositive and seronegative men: the multicenter aids cohort study. AIDS behav. 2015;20(3):622–32.

    Article  Google Scholar 

  15. Balsam KF, Beadnell B, Riggs KR. Understanding sexual orientation health disparities in smoking: a population-based analysis. Am J orthopsychiatry. 2012;82(4):482–93.

    Article  PubMed  Google Scholar 

  16. Gruskin EP, Greenwood GL, Matevia M, Pollack LM, Bye LL. Disparities in smoking between the lesbian, gay, and bisexual population and the general population in California. Am J Public Health. 2007;97(8):1496–502.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wojna V, Robles L, Skolasky RL, Mayo R, Selnes O, de la Torre T, et al. Associations of cigarette smoking with viral immune and cognitive function in human immunodeficiency virus-seropositive women. J Neurovirol. 2007;13(6):561–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. O’Cleirigh C, Valentine SE, Pinkston M, Herman D, Bedoya CA, Gordon JR, et al. The unique challenges facing HIV-positive patients who smoke cigarettes: HIV viremia, ART adherence, engagement in HIV care, and concurrent substance use. AIDS Behav. 2015;19:178–85.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hile SJ, Feldman MB, Alexy ER, Irvine MK. Recent tobacco smoking is associated with poor HIV medical outcomes among HIV-infected individuals in New York. AIDS behav. 2016;20:1722–9.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Cropsey KL, Willig JH, Mugavero MJ, Crane HM, McCullumsmith C, Lawrence S, et al. Cigarette smokers are less likely to have undetectable viral loads: results from four HIV clinics. J Addict Med. 2016;10(1):13–9.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Moreno JL, Catley D, Lee HS, Goggin K. The relationship between ART adherence and smoking status among HIV+ individuals. AIDS Behav. 2015;19(4):619–25.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Nguyen NTP, Tran BX, Hwang LY, Markham CM, Swartz MD, Vidrine JI, et al. Effects of cigarette smoking and nicotine dependence on adherence to antiretroviral therapy among HIV-positive patients in Vietnam. AIDS Care. 2015;1–6.

  23. King RM, Vidrine DJ, Danysh HE, Fletcher FE, McCurdy S, Arduino RC, et al. Factors associated with nonadherence to antiretroviral therapy in HIV-positive smokers. AIDS Patient Care STDS. 2012;26(8):479–85.

    Article  PubMed  Google Scholar 

  24. McKee SA, Falba T, O’Malley SS, Sindelar J, O’Connor PG. Smoking status as a clinical indicator for alcohol misuse in US adults. Arch Intern Med. 2007;167(7):716–21.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kahler CW, Wray TB, Pantalone DW, Kruis RD, Mastroleo NR, Monti PM, et al. Daily associations between alcohol use and unprotected anal sex among heavy drinking HIV-positive men who have sex with men. AIDS behav. 2014;19(3):422–30.

    Article  Google Scholar 

  26. Sobell M, Sobell L. Problem drinkers: guided self-change treatment. New York: Guilfoed Press; 1993.

    Google Scholar 

  27. Fals-Stewart W, O’Farrell T, Freitas T, McFarlin S, Rutigliano P. The timeline followback reports of psychoactive substance use by drug-abusing patients: psychometric properties. J Consult Clin Psychol. 2000;61(1):134–44.

    Article  Google Scholar 

  28. Morgenstern J, Bux D Jr, Parsons J, Hagman B, Wainberg M, Irwin T. Randomized trial to reduce club drug use and HIV risk behaviors among men who have sex with men. J Consult Clin Psychol. 2009;77(4):645–56.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Irwin T, Morgenstern J, Parsons J, Wainberg M, Labouvie E. Alcohol and sexual HIV risk behavior among problem drinking men who have sex with men: an event level analysis of timeline followback data. AIDS Behav. 2006;10(3):299–307.

    Article  PubMed  Google Scholar 

  30. Velasquez M, von Sternberg K, Johnson D, Green C, Carbonari J, Parsons J. Reducing sexual risk behaviors and alcohol use among HIV-positive men who have sex with men: a randomized clinical trial. J Consult Clin Psychol. 2009;77(4):657–67.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Parsons J, Kowalcyzk W, Botsko M, Tomassilli J, Golub S. Aggregate versus day level associations between methamphetamine use and HIV medication non-adherence among gay and bisexual men. AIDS Behav. 2013;17(4):1478–87.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Parsons J, Golub S, Rosof E, Holder C. Motivational interviewing and cognitive behavioral intervention to improve medication adherence among hazardous drinkers. J Acquir Immune Defic Syndr. 2007;46(4):443–50.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Ingersoll KS, Farrell-Carnahan L, Cohen-Filipic J, Heckman CJ, Ceperich SD, Hettema J, et al. A pilot randomized clinical trial of two medication adherence and drug use interventions for HIV+ crack cocaine users. Drug Alcohol Depend. 2011;116(1–3):177–87.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Parsons J, Rosof E, Mustanski B. Medication adherence mediates the relationship between adherence self-efficacy and biological assessments of HIV health among those with alcohol use disorders. AIDS Behav. 2008;12(1):95–103.

    Article  PubMed  Google Scholar 

  35. Paterson D, Swindells S, Mohr J, Brester M, Vergis E, Squier C, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21–30.

    Article  CAS  PubMed  Google Scholar 

  36. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(Summer):385–401.

    Article  Google Scholar 

  37. Tedaldi EM, van den Berg-Wolf M, Richardson J, Patel P, Durham M, Hammer J, et al. Sadness in the SUN: using computerized screening to analyze correlates of depression and adherence in HIV-infected adults in the United States. AIDS Patient Care STDS. 2012;26(12):718–7129.

    Article  PubMed  Google Scholar 

  38. Blashill AJ, Bedoya CA, Mayer KH, O’Cleirigh C, Pinkston MM, Remmert JE, et al. Psychosocial syndemics are additively associated with worse ART adherence in HIV-infected individuals. AIDS Behav. 2015;19(6):981–6.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Friedman MR, Stall R, Silvestre AJ, Wei C, Shoptaw S, Herrick A, et al. Effects of syndemics on HIV viral load and medication adherence in the multicentre AIDS cohort study. AIDS. 2015;29(9):1087–96.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Pellowski JA, Kalichman SC, Matthews KA, Adler N. A pandemic of the poor: social disadvantage and the U.S. HIV epidemic. Am Psychol. 2013;68(4):197–209.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Safren SA, Blashill AJ, O’Cleirigh CM. Promoting the sexual health of MSM in the context of comorbid mental health problems. AIDS Behav. 2011;15(Suppl 1):S30–4.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Webb MS, Vanable PA, Carey MP, Blair DC. Medication adherence in HIV-infected smokers: the mediating role of depressive symptoms. AIDS Educ Prev. 2009;21:95–105.

    Article  Google Scholar 

  43. Musinguzi N, Muganzi CD, Boum Y 2nd, Ronald A, Marzinke MA, Hendrix CW, et al. Comparison of subjective and objective adherence measures for preexposure prophylaxis against HIV infection among serodiscordant couples in East Africa. AIDS. 2016;30(7):1121–9.

    Article  PubMed  Google Scholar 

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Acknowledgments

Funding

This work was supported by Grant number P01 AA019072 from the National Institute on Alcohol Abuse and Alcoholism, grant number K23NR014951 from the National Institute for Nursing Research, and grant number T32MH 078788 from the National Institute of Mental Health at the National Institutes of Health.

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Authors and Affiliations

  1. Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA

    Patricia A. Cioe, Peter M. Monti & Christopher W. Kahler

  2. Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA

    Kristi E. Gamarel

  3. University of Massachusetts Boston, Boston, MA, USA

    David W. Pantalone

  4. Harvard University School of Public Health, Boston, MA, USA

    Kenneth H. Mayer

  5. Fenway Community Health Center, Boston, MA, USA

    Kenneth H. Mayer

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  1. Patricia A. Cioe
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Correspondence to Patricia A. Cioe.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cioe, P.A., Gamarel, K.E., Pantalone, D.W. et al. Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM). AIDS Behav 21, 1956–1963 (2017). https://doi.org/10.1007/s10461-016-1496-5

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