The Influence of HIV Disease Events/Stages on Smoking Attitudes and Behaviors

摘要： 虽然可归因于艾滋病相关疾病的死亡率在 高效抗逆转录病毒疗法(HAART)时代，可归因于 其他疾病(如心血管疾病、肺部疾病和癌症) 明显增加。因此，减少可归因于这些疾病的发病率和死亡率的努力 非艾滋病定义的疾病是一项重要的公共卫生优先事项。一种方法 要改善这一人群的健康结果，就必须针对危害健康的行为，例如 抽烟。现有的证据表明，吸烟的流行率很高 在艾滋病毒/艾滋病患者中升高。此外，吸烟与 许多与艾滋病毒相关的不良后果。尽管有这些发现，但几乎没有什么努力 为这群人提供戒烟治疗。同样缺乏的是探索的努力 HIV疾病事件/阶段与吸烟之间的关系。因此，最重要的是 该项目的目标是前瞻性地探索艾滋病毒疾病与 事件/阶段、艾滋病毒的感知影响、对吸烟的态度和吸烟 行为。艾滋病毒疾病事件/阶段(例如，艾滋病毒诊断时间，疾病进展， 和稳定的疾病)将被评估为吸烟的潜在可教时刻 停止。具体地说，我们将识别和招募新诊断为艾滋病毒的吸烟者 大型市中心艾滋病毒/艾滋病护理中心，为不同种族/民族的医疗人员提供服务 贫困人口。参与者将完成计算机管理的评估 旨在衡量艾滋病毒的感知影响、对吸烟的态度以及目前 在研究入学时的吸烟行为。除了传统自我报告之外 将使用以下方法评估某些变量(例如，感知到的艾滋病毒影响) “隐含的”认知心理测量，因为大量证据表明， 显性和隐性措施产生了预测结果的独特信息。 参与者将被跟踪一年，并被要求完成后续计算机- 每隔三个月进行一次评估。除了诊所管理之外 评估，参与者将完成每周简短的电话评估，以便 美国将仔细跟踪疾病和吸烟行为对 前三个月的随访。研究人员还将进行医疗记录 检查以记录疾病的时间和进展(例如，治疗失败， 艾滋病毒相关或非艾滋病毒相关疾病的诊断)。这种设计将使我们能够仔细地 跟踪吸烟行为随时间的变化，并将这些变化与 艾滋病毒病程和/或参与者对艾滋病毒的感知影响。通过识别 最佳干预时间点，调查结果将有可能最大化 在资源有限的情况下提供戒烟治疗的效率和效果。在……里面 此外，研究结果将有助于确定应该 有针对性的干预，并将为发展 未来针对艾滋病毒/艾滋病吸烟者的戒烟干预。项目叙事 这项拟议的研究将提供有关艾滋病毒与疾病之间关系的重要信息。 社会经济地位低、种族/民族多元化的事件/阶段与吸烟行为 人口。具体地说，研究结果将确定戒烟干预的潜在可教时刻 艾滋病的病程，并将为未来戒烟的发展提供坚实的基础 针对这一人群的干预措施。

Abstract: While mortality attributable to AIDS-related diseases has decreased dramatically in the highly active antiretroviral therapy (HAART) era, the proportion of deaths attributable to other diseases (e.g., cardiovascular disease, pulmonary disease, and cancer) has markedly increased. Thus, efforts to reduce morbidity and mortality attributable to these non-AIDS defining diseases represent an important public health priority. One approach to improve health outcomes for this population is to target health-risk behaviors, such as cigarette smoking. Existing evidence indicates that smoking prevalence is significantly elevated among persons living with HIV/AIDS. In addition, smoking is associated with numerous HIV-related adverse outcomes. Despite these findings, few efforts have been made to deliver cessation treatment to this population. Also lacking are efforts to explore the relationship between HIV disease events/stages and smoking. Thus, the overarching goal of this project is to prospectively explore the relationship between HIV disease events/stages, perceived impact of HIV, attitudes about smoking, and smoking behaviors. HIV disease events/stages (e.g., time of HIV diagnosis, progressive disease, and stable disease) will be evaluated as potential teachable moments for smoking cessation. Specifically, we will identify and recruit newly HIV-diagnosed smokers from a large, inner city HIV/AIDS care center serving a racially/ethnically diverse, medically indigent population. Participants will complete a computer-administered assessment designed to measure perceived impact of HIV, attitudes about smoking, and current smoking behavior at the time of study enrollment. In addition to traditional self-report measures, certain variables (e.g., perceived impact of HIV) will be assessed using "implicit" cognitive psychological measures, as considerable evidence suggests that both explicit and implicit measures yield unique information that predicts outcome. Participants will be followed for one year and asked to complete follow-up computer- administered assessments at three-month intervals. In addition to clinic administered assessments, participants will complete brief weekly phone assessments that will allow us to carefully track changes in perceived impact of disease and smoking behavior for the first three months of follow-up. Research staff will also conduct medical record reviews to document the timing and progression of disease (e.g., treatment failure, diagnosis of an HIV- or non-HIV related disease). This design will enable us to carefully track changes in smoking behavior over time, and to link these changes to both the course of HIV-disease and/or to participants' perceived impact of HIV. By identifying optimal time points for intervention, findings will have the potential to maximize the efficiency and efficacy of cessation treatments delivered in resource-limited settings. In addition, findings will be instrumental in identifying specific constructs that should be targeted for intervention, and will provide a strong foundation for the development of future cessation interventions targeting smokers living with HIV/AIDS. Project Narrative The proposed study will provide important information about the relationship between HIV-disease events/stages and smoking behavior among a low socio-economic status, racially/ethnically diverse population. Specifically, findings will identify potential teachable moments for cessation interventions in the course of HIV-disease, and will provide a strong foundation for the development of future cessation interventions targeting this population.