A Pilot Study of Positively Smoke Free on the Web (PSFW) for HIV-infected Smokers

描述（由申请人提供）：美国有110万艾滋病病毒感染者（PLWH），其中60%吸烟，75%有戒烟意向。三分之二的人使用互联网。目前，几乎没有人能够获得旨在满足其具体需求和关切的戒烟干预措施。 吸烟是导致艾滋病毒感染者死亡的24%，以及30%的非艾滋病定义的恶性肿瘤。它正在推动这一高度脆弱人群中肺癌的惊人增长。无法获得经证实的、有效的、文化上适当的戒烟服务是一种最严重的健康差距。艾滋病毒/艾滋病感染者-吸烟者群体的社会心理状况，其特点是精神病合并症、药物和酒精使用率高，社会支持水平低，这表明实现高戒烟率将是一个巨大的挑战。 Positively Smoke Free on the Web是第一个专门为PLWH吸烟者开发的基于网络的戒烟计划。它是一种可供临床使用的资源，但其可行性和有效性还有待研究。该提案的主要目标是（1）在69名PLWH吸烟者的队列中评估网站的可行性（即招募、依从性、保留和满意度），以及（2）完成一项前瞻性、随机对照试验，比较在线计划与标准治疗（总N=138）的疗效，主要结局为3个月的时点流行率戒烟。 如果该计划被证明是有效的，该项目将通过为服务不足的高优先级人群提供广泛可用的免费烟草治疗选择，并通过为PLWH吸烟者优化网络治疗的进一步研究提供信息，产生短期影响。长期影响将是减少艾滋病毒携带者中与烟草有关的发病率和死亡率，并更清楚地了解有针对性的、基于网络的卫生干预措施在艾滋病毒综合护理中的作用。

DESCRIPTION (provided by applicant): There are 1.1 million persons living with HIV (PLWH) in the US, 60% of them smoke cigarettes, and 75% of them are interested in quitting. Two-thirds of them use the internet. Almost none are currently accessing smoking cessation interventions designed to meet their specific needs and concerns. Cigarette smoking is responsible for 24% of deaths among PLWH, and 30% of non-AIDS defining malignancies. It is driving the alarming rise in lung cancers in this highly vulnerable population. The lack of access to proven, effective, culturally appropriate tobacco cessation services represents a health disparity of the first order. The psychosocial profile of the PLWH-smoker community, characterized by high rates of psychiatric comorbidity, drug and alcohol use, and low levels of social support, suggests that achieving high cessation rates will be a great challenge. Positively Smoke Free on the Web is the first web-based cessation program developed expressly for PLWH smokers. It is a resource that is ready for clinical use, but its feasibility and efficacy have yet to be studied. The main goals of this proposal are (1) to evaluate the website's feasibility (i.e. recruitment, adherence, retention, and satisfaction) in a cohort of 69 PLWH smokers, and (2) to complete a prospective, randomized controlled trial comparing the efficacy of the online program to standard care (total N=138) with a primary outcome of 3 month point-prevalence abstinence. If the program is proven to be efficacious, the project will have short term impact by offering a broadly available, free option for tobacco treatment to an underserved, high-priority population, and by informing further research on the optimization of web-based treatment for PLWH smokers. The long-term impact will be reduced tobacco-related morbidity and mortality among PLWH, and a clearer understanding of the role of targeted, web-based health interventions in comprehensive HIV care.