Skip to main content

Advertisement

SpringerLink
Log in

Treatment Outcomes Associated with Quitting Cigarettes Among Sexual Minority Men Living with HIV: Antiretroviral Adherence, Engagement in Care, and Sustained HIV RNA Suppression

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Cigarette smoking is particularly harmful for sexual minority men living with HIV. This study aimed to find benefits of quitting by examining relationships between smoking and sustained HIV RNA suppression, recent CD4 count, ART medication adherence, and engagement in HIV medical care. Sexual minority men (n = 346), former or current smokers, received HIV care at a community health center. Survey responses were combined with electronic health record data in adjusted regression models. Most patients were Caucasian (87%) and 148 (46%) had incomes below the poverty level and 80% had sustained HIV RNA suppression. Compared to current smokers, former smokers had increased odds of sustaining HIV RNA suppression (OR 1.89; 95% CI 1.02–3.48) of reporting > 90% adherence (OR 2.25; 95% CI 1.21–4.17), and were less likely to miss appointments (OR 0.37; 95% CI 0.17–0.82). Heavier smokers (OR 0.36; 95% CI 0.17–0.77) and patients who smoked the longest (OR 0.31; 95% CI 0.14–0.68) had reduced odds of sustaining HIV RNA suppression. Smoking assessment, treatment, and referral could augment HIV outcomes for sexual minority men with HIV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. U.S. Department of Health and Human Services (USDHHS). The health consequences of smoking: 50 years of progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2014.

  2. Baggett TP, Lebrun-Harris LA, Rigotti NA. Homelessness, cigarette smoking and desire to quit: results from a US national study. Addiction. 2013;108:2009–18.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tessaro I, Lyna PR, Rimer BK, et al. Readiness to change smoking behavior in a community health center population. J Community Health. 1997;22:15–31.

    Article  PubMed  CAS  Google Scholar 

  4. Lifson AR, Neuhaus J, Arribas JR, et al. Smoking-related health risks among persons with HIV in the strategies for management of antiretroviral therapy clinical trial. Am J Public Health. 2010;100:1896–903.

    Article  PubMed  PubMed Central  Google Scholar 

  5. O’Cleirigh C, Valentine SE, Pinkston M, 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 

  6. Pines H, Koutsky L, Buskin S. Cigarette smoking and mortality among HIV-infected individuals in Seattle, Washington (1996–2008). AIDS Behav. 2011;15:243–51.

    Article  PubMed  Google Scholar 

  7. Tesoriero JM, Gieryic SM, Carrascal A, et al. Smoking among HIV positive New Yorkers: prevalence, frequency, and opportunities for cessation. AIDS Behav. 2010;14:824–35.

    Article  PubMed  Google Scholar 

  8. Webb MS, Vanable PA, Carey MP, et al. Cigarette smoking among HIV + men and women: examining health, substance use, and psychosocial correlates across the smoking spectrum. J Behav Med. 2007;30:371–83.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Halloran J. Increasing survival with HIV: impact on nursing care. AACN Clin Issues. 2006;17:8–17.

    Article  PubMed  Google Scholar 

  10. Engels EA, Brock MV, Chen J, et al. Elevated incidence of lung cancer among HIV-infected individuals. J Clin Oncol. 2006;24:1383–8.

    Article  PubMed  Google Scholar 

  11. Lifson AR, Lando HA. Smoking and HIV: prevalence, health risks, and cessation strategies. Curr HIV/AIDS Rep. 2012;9:223–30.

    Article  PubMed  Google Scholar 

  12. Miguez-Burbano MJ, Burbano X, Ashkin D, et al. Impact of tobacco use on the development of opportunistic respiratory infections in HIV seropositive patients on antiretroviral therapy. Addict Biol. 2003;8:39–43.

    Article  PubMed  Google Scholar 

  13. De Socio GV, Martinelli L, Morosi S, et al. Is estimated cardiovascular risk higher in HIV-infected patients than in the general population? Scand J Infect Dis. 2007;39:805–12.

    Article  PubMed  Google Scholar 

  14. De Socio GV, Parruti G, Quirino T, et al. Identifying HIV patients with an unfavorable cardiovascular risk profile in the clinical practice: results from the SIMONE study. J Infect. 2008;57:33–40.

    Article  PubMed  Google Scholar 

  15. Browning KK, Wewers ME, Ferketich AK, et al. Tobacco use and cessation in HIV-infected individuals. Clin Chest Med. 2013;34:181–90.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Petrache I, Diab K, Knox KS, et al. HIV associated pulmonary emphysema: a review of the literature and inquiry into its mechanism. Thorax. 2008;63:463–9.

    Article  PubMed  CAS  Google Scholar 

  17. Cui Q, Carruthers S, McIvor A, et al. Effect of smoking on lung function, respiratory symptoms and respiratory diseases amongst HIV-positive subjects: a cross-sectional study. AIDS Res Ther. 2010;7:6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. van Zyl Smit RN, Pai M, Yew WW, et al. Global lung health: the colliding epidemics of tuberculosis, tobacco smoking, HIV and COPD. Eur Respir J. 2010;35:27–33.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Winstone TA, Man SF, Hull M, et al. Epidemic of lung cancer in patients with HIV infection. Chest. 2013;143:305–14.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  20. De P, Farley A, Lindson N, et al. Systematic review and meta-analysis: influence of smoking cessation on incidence of pneumonia in HIV. BMC Med. 2013;11:15.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Cropsey KL, Willig JH, Mugavero MJ, et al. Cigarette smokers are less likely to have undetectable viral loads: results from four HIV clinics. J Addict Med. 2016;10:13–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Peretti-Watel P, Spire B, Lert F, et al. Drug use patterns and adherence to treatment among HIV-positive patients: evidence from a large sample of French outpatients (ANRS-EN12-VESPA 2003). Drug Alcohol Depend. 2006;82(Suppl 1):S71–9.

    Article  PubMed  Google Scholar 

  23. Shuter J, Bernstein SL. Cigarette smoking is an independent predictor of nonadherence in HIV-infected individuals receiving highly active antiretroviral therapy. Nicotine Tob Res. 2008;10:731–6.

    Article  PubMed  CAS  Google Scholar 

  24. Gardner EM, McLees MP, Steiner JF, et al. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52:793–800.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Traeger L, O’Cleirigh C, Skeer MR, et al. Risk factors for missed HIV primary care visits among men who have sex with men. J Behav Med. 2012;35:548–56.

    Article  PubMed  Google Scholar 

  26. Cashman SB, Savageau JA, Lemay CA, et al. Patient health status and appointment keeping in an urban community health center. J Health Care Poor Underserved. 2004;15:474–88.

    Article  PubMed  Google Scholar 

  27. Mugavero MJ, Amico KR, Westfall AO, et al. Early retention in HIV care and viral load suppression: implications for a test and treat approach to HIV prevention. J Acquir Immune Defic Syndr. 2012;59:86–93.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hile S, Feldman M, Alexy E, Irvine M. Recent tobacco smoking is associated with poor HIV medical outcomes among HIV-infected individuals in New York. AIDS Behav. 2016;20(8):1722–9.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Sopori M. Effects of cigarette smoke on the immune system. Nat Rev Immunol. 2002;2(5):372–7.

    Article  PubMed  CAS  Google Scholar 

  30. Kalra R, Singh S, Savage S, Finch G, Sopori M. Effects of cigarette smoke on immune response: chronic exposure to cigarette smoke impairs antigen-mediated signaling in T cells and depletes IP3-sensitive Ca(2 +) stores. J Pharmacol Exp Ther. 2000;293(1):166–71.

    PubMed  CAS  Google Scholar 

  31. Batchelder A, Brisbane M, Litwin A, Nahvi S, Berg K, Arnsten J. “Damaging what wasn’t damaged already”: psychological tension and antiretroviral adherence among HIV-infected methadone-maintained drug users. AIDS Care. 2013;25(11):1370–4.

    Article  PubMed  CAS  Google Scholar 

  32. Batchelder A, Peyser D, Nahvi S, Arnsten J, Litwin A. Hepatitis C treatment turned me around: psychological and behavioral transformation related to hepatitis C treatment. Drug Alcohol Depend. 2015;153:66–71.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  33. Centers for Disease Control and Prevention. HIV among Gay and Bisexual and men. 2010. https://www.cdc.gov/hiv/pdf/group/msm/cdc-hiv-msm.pdf. Accessed 26 Oct 2017.

  34. King BA, Dube SR, Tynan MA. Current tobacco use among adults in the United States: findings from the national adult tobacco survey. Am J Public Health. 2012;102(11):e93–100.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Lee JGL, Griffin GK, Melvin CL. Tobacco use among sexual minorities in the USA, 1987 to May 2007: a systematic review. Tob Control. 2009;18(4):275–82.

    Article  PubMed  CAS  Google Scholar 

  36. Burgess D, Lee R, Tran A, Van Ryn M. Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons. J LGBT Health Res. 2008;3(4):1–14.

    Article  Google Scholar 

  37. Hatzenbuehler ML, Wieringa NF, Keyes KM. Community-level determinants of tobacco use disparities in lesbian, gay, and bisexual youth: results from a population-based study. Arch Pediatr Adolesc Med. 2011;165(6):527–32.

    Article  PubMed  Google Scholar 

  38. Bontempo DE, D’Augelli AR. Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior. J Adolesc Health. 2002;30(5):364–74.

    Article  PubMed  Google Scholar 

  39. Willoughby BLB, Doty ND, Malik NM. Victimization, family rejection, and outcomes of gay, lesbian, and bisexual young people: the role of negative GLB identity. J GLBT Fam Stud. 2010;6(4):403–24.

    Article  Google Scholar 

  40. Case P, Bryn Austin S, Hunter DJ, et al. Sexual orientation, health risk factors, and physical functioning in the nurses’ Health Study II. J Womens Health. 2004;13(9):1033–47.

    Article  Google Scholar 

  41. Blosnich J, Jarrett T, Horn K. Disparities in smoking and acute respiratory illnesses among sexual minority young adults. Lung. 2010;188(5):401–7.

    Article  PubMed  Google Scholar 

  42. Landers SJ, Mimiaga MJ, Conron KJ. Sexual orientation differences in asthma correlates in a population-based sample of adults. Am J Public Health. 2011;101(12):2238–41.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Heck JE, Jacobson JS. Asthma diagnosis among individuals in same-sex relationships. J Asthma. 2006;43(8):579–84.

    Article  PubMed  Google Scholar 

  44. Kitahata MM, Rodriguez B, Haubrich R, et al. Cohort profile: the centers for AIDS research network of integrated clinical systems. Int J Epidemiol. 2008;37:948–55.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Crane HM, Lober W, Webster E, et al. Routine collection of patient-reported outcomes in an HIV clinic setting: the first 100 patients. Curr HIV Res. 2007;5:109–18.

    Article  PubMed  CAS  Google Scholar 

  46. Amico KR, Fisher WA, Cornman DH, Shuper PA, Redding CG, Konkle-Parker DJ, Barta W, Fisher JD. Visual analog scale of ART adherence: association with 3-day self-report and adherence barriers. J Acquir Immune Defic Syndr. 2006;42(4):455–9.

    Article  PubMed  Google Scholar 

  47. Simoni JM, Kurth AE, Pearson CR, Pantalone DW, Merrill JO, Frick PA. Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS Behav. 2006;10(3):227–45.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Gordon L, Gharibian D, Chong K, Chun H. Comparison of HIV virologic failure rates between patients with variable adherence to three antiretroviral regimen types. AIDS Patient Care Stds. 2015;29(7):384–8.

    Article  PubMed  Google Scholar 

  49. DHHS. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. Washington, DC: US Department of Health and Human Services. 2010. http://AIDSinfo.nih.gov.

  50. Deeks SG, Walker BD. Human immunodeficiency virus controllers: mechanisms of durable virus control in the absence of antiretroviral therapy. Immunity. 2007;27:406–16.

    Article  PubMed  CAS  Google Scholar 

  51. Crothers K, Griffith TA, McGinnis KA, et al. The impact of cigarette smoking on mortality, quality of life, and comorbid illness among HIV-positive veterans. J Gen Intern Med. 2005;20:1142–5.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Wojna V, Robles L, Lasalde-Dominicci J, 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  PubMed  PubMed Central  CAS  Google Scholar 

  53. Williams EC, Bradley KA, Balderson BH, et al. Alcohol and associated characteristics among older persons living with human immunodeficiency virus on antiretroviral therapy. Subst Abus. 2014;35:245–53.

    Article  PubMed  PubMed Central  Google Scholar 

  54. De Boni RB, Zheng L, Rosenkranz SL, et al. Binge drinking is associated with differences in weekday and weekend adherence in HIV-infected individuals. Drug Alcohol Depend. 2016;159:174–80.

    Article  PubMed  Google Scholar 

  55. Mohammed H, Kieltyka L, Richardson-Alston G, et al. Adherence to HAART among HIV-infected persons in rural Louisiana. AIDS Patient Care STDS. 2004;18:289–96.

    Article  PubMed  Google Scholar 

  56. Skeer MR, Mimiaga MJ, Mayer KH, et al. Patterns of substance use among a large urban cohort of HIV-infected men who have sex with men in primary care. AIDS Behav. 2012;16:676–89.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Treisman G, Angelino A. Interrelation between psychiatric disorders and the prevention and treatment of HIV infection. Clin Infect Dis. 2007;45(Suppl 4):S313–7.

    Article  PubMed  Google Scholar 

  58. Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58:721–8.

    Article  PubMed  CAS  Google Scholar 

  59. King RM, Vidrine DJ, Danysh HE, et al. Factors associated with nonadherence to antiretroviral therapy in HIV-positive smokers. AIDS Patient Care STDS. 2012;26:479–85.

    Article  PubMed  Google Scholar 

  60. Glass TR, Battegay M, Cavassini M, et al. Longitudinal analysis of patterns and predictors of changes in self-reported adherence to antiretroviral therapy: swiss HIV Cohort Study. J Acquir Immune Defic Syndr. 2010;54:197–203.

    PubMed  Google Scholar 

  61. Taniguchi T, Shacham E, Onen NF, et al. Depression severity is associated with increased risk behaviors and decreased CD4 cell counts. AIDS Care. 2014;26:1004–12.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Sin NL, DiMatteo MR. Depression treatment enhances adherence to antiretroviral therapy: a meta-analysis. Ann Behav Med. 2014;47:259–69.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Bondy SJ, Victor JC, Diemert LM. Origin and use of the 100 cigarette criterion in tobacco surveys. Tob Control. 2009;18:317–23.

    Article  PubMed  CAS  Google Scholar 

  64. Balaji A, Bowles K, Le B, Paz-Bailey G, Oster A. High HIV incidence and prevalence and associated factors among young MSM. AIDS. 2008;27(2):269–78.

    Article  Google Scholar 

  65. Gerend M, Newcomb M, Mustanski B. Prevalence and correlates of smoking and e-cigarette use among young men who have sex with men and transgender women. Drug Alcohol Depend. 2017;179:395–9.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Easton A, Jackson K, Mowery P, Comeau D, Sell R. Adolescent same-sex and both-sex romantic attractions and relationships: implications for smoking. Am J Public Health. 2008;98:462–7.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Austin SB, Ziyadeh N, Fisher LB, et al. Sexual orientation and tobacco use in a cohort study of US adolescent girls and boys. Arch Pediatr Adolesc Med. 2004;158:317–22.

    Article  PubMed  Google Scholar 

  68. Humfleet GL, Hall SM, Delucchi KL, et al. A randomized clinical trial of smoking cessation treatments provided in HIV clinical care settings. Nicotine Tob Res. 2013;15:1436–45.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Krebs P, Tseng TY, Pham H, et al. Formative evaluation of a text messaging intervention to promote varenicline adherence among tobacco-dependent persons with HIV. J Health Commun. 2015;20:1021–5.

    Article  PubMed  Google Scholar 

  70. Vidrine DJ, Marks RM, Arduino RC, et al. Efficacy of cell phone-delivered smoking cessation counseling for persons living with HIV/AIDS: 3-month outcomes. Nicotine Tob Res. 2012;14:106–10.

    Article  PubMed  Google Scholar 

  71. Aveyard P, Begh R, Parsons A, et al. Brief opportunistic smoking cessation interventions: a systematic review and meta-analysis to compare advice to quit and offer of assistance. Addiction. 2012;107:1066–73.

    Article  PubMed  Google Scholar 

  72. Webster PC. United States to compel physicians to make “meaningful use” of electronic health records. CMAJ. 2010;182(14):1500. https://doi.org/10.1503/cmaj.109-3361.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Bae J, Ford EW, Huerta TR. The electronic medical record’s role in support of smoking cessation activities. Nicotine Tob Res. 2016;18(5):1019–24.

    Article  PubMed  Google Scholar 

Download references

Funding

Dr. Conall O’Cleirigh’s time on this manuscript was supported in part by National Institute of Drug Abuse (NIDA) Grant 1R34DA031038-01A (PI. O’Cleirigh).

Author information

Authors and Affiliations

  1. The Fenway Institute, Fenway Health, Boston, MA, 02118, USA

    Dana King, Chris Grasso, Lydia Dant, Steven A. Elsesser, Kenneth H. Mayer & Conall O’Cleirigh

  2. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Steven A. Elsesser

  3. University of Washington, Seattle, WA, USA

    Heidi M. Crane

  4. University of Alabama at Birmingham (UAB), Birmingham, AL, USA

    Karen L. Cropsey

  5. Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kenneth H. Mayer

  6. Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Conall O’Cleirigh

Authors
  1. Dana King
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chris Grasso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lydia Dant
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Steven A. Elsesser
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Heidi M. Crane
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Karen L. Cropsey
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kenneth H. Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Conall O’Cleirigh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dana King.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

King, D., Grasso, C., Dant, L. et al. Treatment Outcomes Associated with Quitting Cigarettes Among Sexual Minority Men Living with HIV: Antiretroviral Adherence, Engagement in Care, and Sustained HIV RNA Suppression. AIDS Behav 22, 2868–2876 (2018). https://doi.org/10.1007/s10461-018-2116-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-018-2116-3

Keywords

Search

Navigation