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A Pilot Trial Examining African American and White Responses to Algorithm-Guided Smoking Cessation Medication Selection in Persons Living with HIV

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Abstract

Algorithm-based treatments (AT) may be an effective clinical tool to aid HIV clinicians in prescribing pharmacotherapy to increase smoking cessation among people living with HIV (PLWH). Initial results from AT indicated significant increases in abstinence self-efficacy and medication utilization and declines in cigarettes smoked per day across time. Given historical racial disparities, it is unclear if both African Americans and White smokers would benefit equally from this type of intervention. Thus, the aim of this study was to examine racial differences in response to AT guided smoking cessation for African American and White smokers living with HIV. One hundred PLWH smokers (n = 100) were randomized to receive either AT guided smoking cessation or Treatment as Usual (TAU) which consisted of instructing participants to talk to a provider about smoking cessation assistance when ready to make a quit attempt. Participants were African American (75%) and White (25%) and majority men (71%) who had never been married (56%). African Americans smoked fewer cigarettes and were more likely to smoke mentholated cigarettes compared to White smokers at baseline. African Americans increased their use of other tobacco products (cigars/cigarillos) over time relative to White smokers. A significant interaction between race and quit goal was observed, with White smokers who reported complete abstinence as their goal having higher quit rates, while African Americans who reported a goal other than complete abstinence demonstrating higher quit rates. The increased use of cigars/cigarillos during quit attempts as well as having a goal other than complete abstinence should be considered when applying algorithm based interventions for PLWH African American smokers.

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Funding

Supported by the University of Alabama at Birmingham (UAB) Center For AIDS Research CFAR, an NIH-funded program (P30 AI027767) that was made possible by the following institutes: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, NIDDK, NIGMS, FIC, and OAR.

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Authors and Affiliations

  1. Division of Social Solutions and Services Research, The Nathan Kline Institute for Psychiatric Research and Department of Psychiatry, New York University School of Medicine, 140 Old Orangeburg Rd, Orangeburg, NY, 10962, USA

    Pamela Valera

  2. Department of Psychiatry and Behavioral Sciences, Addiction Division, Duke University School of Medicine, 2628 Erwin Rd, Durham, NC, 27707, USA

    F. Joseph McClernon

  3. Department of Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, THT 229, Birmingham, AL, 35294, USA

    Greer Burkholder, Michael J. Mugavero & James Willig

  4. Department of Psychiatry, Behavioral Medicine, Massachusetts General Hospital/Harvard Medical School, 1 Bowdoin Square, Boston, MA, 02114, USA

    Conall O’Cleirigh

  5. Department of Psychiatry & Behavioral Neurobiology, University of Alabama at Birmingham, 1720 2nd Ave S., Birmingham, AL, 35294-0017, USA

    Karen L. Cropsey

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  1. Pamela Valera
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Correspondence to Karen L. Cropsey.

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All procedures performed in this study were approved by the University of Alabama at Birmingham’s’ Institutional Review Board and was conducted in accordance with the ethical standards of APA.

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

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Valera, P., McClernon, F.J., Burkholder, G. et al. A Pilot Trial Examining African American and White Responses to Algorithm-Guided Smoking Cessation Medication Selection in Persons Living with HIV. AIDS Behav 21, 1975–1984 (2017). https://doi.org/10.1007/s10461-016-1634-0

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