A randomized controlled trial of a tailored group smoking cessation intervention for HIV-infected smokers.
A randomized controlled trial of a tailored group smoking cessation intervention for HIV-infected smokers.
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DOI：
10.1097/qai.0b013e3182645679
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发表时间：
2012-10-01
期刊：
影响因子：
--
通讯作者：
Shuter J
中科院分区：
文献类型：
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作者：
Moadel AB;Bernstein SL;Mermelstein RJ;Arnsten JH;Dolce EH;Shuter J
在美国，超过一半的艾滋病毒感染者（PLWH）吸烟，烟草使用是造成这一群体相当大的发病率和死亡率的原因。对烟草治疗策略在PLWH中的疗效知之甚少。比较积极无烟（PSF），一种针对HIV感染吸烟者的强化团体治疗干预与标准护理的随机对照试验。从纽约布朗克斯的一家HIV护理中心招募了145名PLWH吸烟者，按1：1的比例随机分配到PSF计划或标准护理中。所有人都接受了为期3个月的尼古丁替代治疗。PSF是一个专门针对艾滋病毒感染吸烟者的需求和关注的八个疗程的计划。会议由一名研究生和一名艾滋病毒感染者共同主持。主要结果是三个月时经生化证实的七天点患病率禁欲。在意向治疗分析中，PSF条件下的受试者戒烟率几乎是对照组的两倍（19.2% vs 9.7%，P = 0.11）。在完整病例中，按治疗分析，分配至PSF与戒烟几率增加相关（ORadj 3.55，95% CI：1.04 - 12.0）。拉丁裔和较低的孤独分数是禁欲的预测。PSF条件下的受试者表现出每日吸烟量显着减少，自我效能和戒烟动机显着增加。参加≥ 7次会议与较高的戒烟率相关。这些发现表明PSF对PLWH吸烟者的戒烟率有积极影响。孤独感和自我效能感是影响艾滋病病毒携带者吸烟行为的重要因素。
More than half of persons living with HIV (PLWH) in the US smoke cigarettes, and tobacco use is responsible for considerable morbidity and mortality in this group. Little is known about the efficacy of tobacco treatment strategies in PLWH. Randomized controlled trial comparing Positively Smoke Free (PSF), an intensive group therapy intervention targeting HIV-infected smokers, to standard care. A cohort of 145 PLWH smokers, recruited from an HIV-care center in the Bronx, New York, were randomized 1:1 into the PSF program or standard care. All were offered a 3-month supply of nicotine replacement therapy. PSF is an eight session program tailored to address the needs and concerns of HIV-infected smokers. Sessions were co-facilitated by a graduate student and an HIV-infected peer. The primary outcome was biochemically-confirmed, seven-day point-prevalence abstinence at three months. In the intention to treat analysis, PSF condition subjects had nearly double the quit rate of controls (19.2% vs 9.7%, P=0.11). In the complete case, as-treated analysis, assignment to PSF was associated with increased odds of quitting (ORadj 3.55, 95% CI: 1.04– 12.0). Latino ethnicity and lower loneliness score were predictive of abstinence. Subjects in the PSF condition exhibited significant decreases in daily cigarette consumption and significant increases in self-efficacy and in motivation to quit. Attendance of ≥7 sessions was associated with higher quit rates. These findings suggest a positive effect of PSF on cessation rates in PLWH smokers. Loneliness and self-efficacy are influential factors in the smoking behaviors of PLWH.