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

Abstract

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.

Resumen

Fumar es altamente prevalente entre las personas VIH-positivas y investigaciones indican que puede ser asociado con la baja adherencia a los medicamentos antiretrovirales aunque la relación no es muy entendible. Además se sabe poco sobre el interés en dejar de fumar entre los fumadores VIH-positivos que están teniendo dificultades de adherencia. Examinamos la relación entre el fumar y adherencia a los medicamentos antiretrovirales entre 203 personas VIH-positivas reclutadas a una investigación aleatoria de intervenciones para aumentar la adherencia antirretroviral. Los análisis previos indicaban que no había efectos globales del grupo de tratamiento. El consumo de tabaco y la motivación para dejar de fumar se evaluó al inicio de la investigación y la adherencia antirretroviral se evaluó en la semana 12, 24, 36, y 48. Análisis de la ecuación de estimación generalizada longitudinal controlando por el efecto del grupo de tratamiento mostro que el consumo de tabaco no se relacionó significativamente con la adherencia con el tiempo. La motivación para dejar de fumar fue alta con el 58 % de personas con intención de dejar de fumar en los próximos 6 meses y el 25 % con la intención de dejar de fumar en los próximos 30 días. Los resultados sugieren que el fumar no está asociado con la adherencia de medicamentos antiretrovirales entre las personas con dificultades de adherencia. Sin embargo, no disminuye la importancia de abordar ambas conductas especialmente dado el interés sustancial de cambiar el consumo de tabaco entre fumadores VIH-positivos.

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Acknowledgments

This research was supported by the National Institutes of Mental Health (R01 MH068197) to KG. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institutes of Mental Health or the Department of Veterans Affairs. We also acknowledge the extraordinary efforts of our MOTIV8 team as well as Robin Aupperle and Jared Bruce for their contributions to this manuscript.

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Correspondence to Jose L. Moreno.

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Moreno, J.L., Catley, D., Lee, H.S. et al. The Relationship Between ART Adherence and Smoking Status Among HIV+ Individuals. AIDS Behav 19, 619–625 (2015). https://doi.org/10.1007/s10461-014-0978-6

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Keywords

  • HIV
  • Medication adherence
  • Smoking