Ethnic Health/Motivating HIV+ Latinos to Quit Smoking

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DESCRIPTION (provided by applicant): Advances in the treatment of HIV disease have shown dramatic effects on improving immune function in a significant proportion of people infected with HIV in the US. For the first time since the beginning of the HIV epidemic, individuals with HIV are faced with the prospect of living longer, healthier lives. Cigarette smoking is highly prevalent among HIV+ individuals and, in addition to the negative health effects associated with smoking, poses unique health risks to those with HIV. Our research program is designed to improve the health and quality of life of HTV+ individuals and determine the most efficacious approaches to smoking cessation for diverse subpopulations of these patients. Building on results from our study of a brief motivational smoking cessation intervention among HIV+ smokers in Southern New England, the primary goal of this research program is to target the intervention specifically to Latino patients. Latinos make up 13% of the population, yet account for 18.5% of all AIDS cases reported through December 2002, making the Latino AIDS rate 4 times higher than that of non-Hispanic Whites.6 Research is limited in the area of HIV among Latinos and there are no studies to date that address the problem of tobacco use among HIV+ Latinos. We propose to address this disparity by focusing this research study on Latino men and women living with HIV/AIDS. Our goal is to develop and evaluate a clinic based culturally tailored smoking cessation treatment for a largely low-income, Latino, HIV+ population. We will compare this culturally sensitive intervention that incorporates a strong social support component to a standard care control condition, in a randomized controlled trial. We hypothesize that those Latinos receiving the Culturally Tailored Intervention will demonstrate greater biochemically verified smoking abstinence rates at 12- months post-baseline than those receiving a Standard Care Intervention control treatment. Hypotheses will be tested regarding the main effect of acculturation on smoking quit rates in the two treatment conditions. Critical information regarding how the intervention reaches patients and with whom it is most effective will be uncovered by examining mediators and moderators of the intervention-smoking cessation relationship. This study will be the first to examine different smoking cessation treatments in a Latino HIV+ population and the results will have implications for importing culturally sensitive and cost effective cessation treatments into clinical care settings.