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Persistent Disparities in Smoking Rates Among PLWH Compared to the General Population in Philadelphia, 2009–2014

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Abstract

Despite reductions in smoking rates in the general population, little is known about recent smoking trends among people living with HIV (PLWH). We compared the risk for smoking and temporal trends in smoking among PLWH and the general population in the Philadelphia metropolitan area between 2009 and 2014. We used weighted logistic regression to assess the relation between HIV and smoking, and examined temporal smoking trends. The adjusted odds ratio (OR) for smoking comparing PLWH to the general population was 1.80 (95% CI 1.55–2.09) after adjusting for socio-economic, demographic, and mental health diagnosis variables. Smoking prevalence decreased in both the PLWH and general populations during the study period, and we did not observe a significant difference in rates of decline between groups (P = 0.54). Despite overall progress in smoking cessation, a disparity persisted in smoking rates between PLWH and the general population, with and without adjustment for socio-economic, demographic, and mental health variables. Further research is needed to understand the mechanisms linking HIV and tobacco use in order to inform public health efforts to reduce smoking among PLWH.

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Funding

This research was supported by the Centers for Disease Control and Prevention through Cooperative Agreement 6 NU62PS004960 to the Philadelphia Department of Public Health (PI: Dr. Brady), R01 CA243914 from the National Cancer Institute (Dr. Gross), and core services and support from the Penn Center for AIDS Research (P30 AI045008) and the Penn Mental Health AIDS Research Center (P30 MH097488).

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Author notes

  1. Robert Gross and Kathleen A. Brady have equal contribution.

Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Cedric H. Bien-Gund & Robert Gross

  2. Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Grace H. Choi, Pamela A. Shaw & Robert Gross

  3. Philadelphia Department of Public Health, AIDS Activities Coordinating Office, Philadelphia, PA, USA

    Grace H. Choi, Antonios Mashas, Melissa Miller & Kathleen A. Brady

  4. Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA

    Robert Gross

Authors
  1. Cedric H. Bien-Gund
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  2. Grace H. Choi
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  6. Robert Gross
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Correspondence to Cedric H. Bien-Gund.

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Conflict of interest

Dr. Gross serves on a Data and Safety Monitoring Board for Pfizer Inc for medication trials unrelated to HIV or smoking.

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Bien-Gund, C.H., Choi, G.H., Mashas, A. et al. Persistent Disparities in Smoking Rates Among PLWH Compared to the General Population in Philadelphia, 2009–2014. AIDS Behav 25, 148–153 (2021). https://doi.org/10.1007/s10461-020-02952-9

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  • DOI: https://doi.org/10.1007/s10461-020-02952-9

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