Smoking cessation after engagement in HIV care in rural Uganda.
Smoking cessation after engagement in HIV care in rural Uganda.
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DOI：
10.1080/09540121.2018.1484070
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发表时间：
2018-12
期刊：
影响因子：
1.7
通讯作者：
Siedner MJ
中科院分区：
文献类型：
--
作者：
Mitton JA;North CM;Muyanja D;Okello S;Vořechovská D;Kakuhikire B;Tsai AC;Siedner MJ
与未感染艾滋病毒的人相比，艾滋病毒感染者（PLWH）更有可能吸烟，但对撒哈拉以南非洲的吸烟行为知之甚少。为了解决这一知识差距，我们将乌干达农村艾滋病毒感染者（PLWH）与未感染艾滋病毒的人相比，描述了他们的戒烟模式。PLWH至少40岁，抗逆转录病毒治疗至少3年，未感染艾滋病毒的个体从临床集水区招募。我们关注的主要结果是戒烟，使用改编的WHO STEPS吸烟问卷进行评估。我们拟合了考克斯比例风险模型，以比较PLWH预护理、PLWH护理和HIV未感染个体之间的戒烟时间。我们发现，与未感染艾滋病毒的个体相比，护理中的PLWH吸烟的可能性较小（40%对49%，p=0.04）。267例既往吸烟者的合并样本中位年龄为56岁（IQR 49-68），56%（n=150）为男性，26%（n=70）为当前吸烟者。在至事件发生时间分析中，未感染HIV的个体和诊所入组前的PLWH戒烟率相似（HR 0.8，95% CI 0.5-1.2）。然而，在参加HIV护理后，PLWH的戒烟风险是未感染HIV的个体的两倍以上，是参加前PLWH的三倍（HR 2.4，95% CI 1.3-4.6，p=0.005和HR 3.0，95% CI 1.6-5.5，p=0.001）。总之，我们观察到在乌干达农村地区参与艾滋病毒护理后，艾滋病毒感染者中戒烟率很高。虽然我们假设更多的初级保健服务和健康咨询可能有助于，未来的研究应该更好地调查这种关联的机制。
People living with HIV (PLWH) are more likely to smoke compared to HIV-uninfected counterparts, but little is known about smoking behaviors in sub-Saharan Africa. To address this gap in knowledge, we characterized smoking cessation patterns among people living with HIV (PLWH) compared to HIV-uninfected individuals in rural Uganda. PLWH were at least 40 years of age and on antiretroviral therapy for at least three years, and HIV-uninfected individuals were recruited from the clinical catchment area. Our primary outcome of interest was smoking cessation, which was assessed using an adapted WHO STEPS smoking questionnaire. We fit Cox proportional hazards models to compare time to smoking cessation between PLWH pre-care, PLWH in care, and HIV-uninfected individuals. We found that, compared to HIV-uninfected individuals, PLWH in care were less likely to have ever smoked (40% vs. 49%, p=0.04). The combined sample of 267 ever-smokers had a median age of 56 (IQR 49–68), 56% (n=150) were male, and 26% (n=70) were current smokers. In time-to-event analyses, HIV-uninfected individuals and PLWH prior to clinic enrollment ceased smoking at similar rates (HR 0.8, 95% CI 0.5–1.2). However, after enrolling in HIV care, PLWH had a hazard of smoking cessation over twice that of HIV-uninfected individuals and three times that of PLWH prior to enrollment (HR 2.4, 95% CI 1.3–4.6, p=0.005 and HR 3.0, 95% CI 1.6–5.5, p=0.001, respectively). In summary, we observed high rates of smoking cessation among PLWH after engagement in HIV care in rural Uganda. While we hypothesize that greater access to primary care services and health counseling might contribute, future studies should better investigate the mechanism of this association.
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影响因子：
4.4
作者：
Kruse, Gina R.;Bangsberg, David R.;Hahn, Judith A.;Haberer, Jessica E.;Hunt, Peter W.;Muzoora, Conrad;Bennett, John P.;Martin, Jeffrey N.;Rigotti, Nancy A.
通讯作者：
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DOI：
10.1016/j.hjdsi.2015.09.006
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