Marseille 2007
| Abstract #290 - Living with HIV, Antiretroviral treatment (ART) experience and tobacco smoking: results from a multi-site cross-sectional study | ||||
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Session: 39.5: Treatment (Parallel) on Tuesday @ 14.00-16.00 in HC Chaired by Robin Hamilton, Raffaele Visintini Authors: Presenting Author: Dr Bruno Spire - INSERM U379, France |
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| Additional Authors: Mr Gabriel Baron, Dr Daniel Garelik, Ms Virginie Villes, Dr Ghislaine Tsimba, Mrs Patrizia Carrieri, Dr France Lert, Dr Philippe Ravaux, Dr Patrick Peretti-Watel, Dr Xavier Duval, | ||||
| Aim: Cardiovascular diseases and lung cancer are becoming competing causes of deaths in people living with HIV and AIDS (PLWHA) on antiretroviral treatment (ART). Whether or not these competing causes of death may be related to an increased exposure to side-effects of treatment or to tobacco smoking remains still unclear. We aimed to assess smoking prevalence among PLWH , to characterise PLWHA smokers and to understand the relationship between tobacco smoking and individuals personal experience with HIV and ART toxicity. | ||||
| Method / Issue: Eighty randomly selected French hospital outpatient departments were included in the study. The survey was carried out on May 30-th 2006 and data collection about tobacco smoking was based on a self-administered questionnaire that was systematically proposed to PLWHA attending the outpatient hospital department for their routine follow-up visit. The questionnaire included information about tobacco smoking, alcohol use and other substance use ( cannabis, heroin, cocaine, poppers etc;) and self-reported side effects. Smoking was defined by occasional or regular smoking in the last month. The questionnaire includes the Fagerstrom test to measure dependence to nicotine. Contacts with their social network and other information such as experience of stigmatisation and disclosure of HIV seropositivity were also collected. Anxiety and depression were assessed by means of the HAD scale. | ||||
| Results / Comments: Out of the 713 PLWHA who were proposed to fill in the questionnaire, 587 accepted (82%). Mean age was 44 years, 69% were men; patients infected through intravenous drug use (IDUs) accounted for the 12%, men who have sex with men (MSM) for 37%. Among respondents, 254 (43%) reported current smoking, and most of them (222, 38%) were daily smokers. Among them, 29 % were classified as highly dependent, 29% as moderately dependent, 20% weakly dependent and 22% as non-dependent (Fagerstrom test). Fourty-eight percent of males reported to be smokers vs 31% among females (p<0.0001); cigarette smoking prevalence reached 81% among IDUs, 48% among MSM and 29% in other HIV-transmission categories). Smokers were younger than non-smokers (43 years vs 46 years, p=0.0002), reported more frequently being in touch with other smokers (73% vs 47%, p<0.0001), having leisure activities (68% vs 52%, p=0.002) and disclosing their HIV status to their family (77% vs 55%, p<0.0001). Alcohol abuse and cannabis use were more frequent in smokers than in non-smokers (31% vs 10%, and 73% vs 10%; p<0.0001, respectively). Self-reported side effects were significantly more reported by smokers than by non-smokers (91% vs 82%, p=0.03). Anxiety and depression as assessed by the HAD scale were significantly more severe in smokers than non-smokers (9.2 vs 7.8 for anxiety (p=0.0011) and 5.5 vs 4.6 for depression (p=0.09. | ||||
| Discussion: Tobacco smoking in PLWHA is frequent and remains associated to specific vulnerable subgroups, other substance use, HIV disclosure and perceived side effects of ART. Strategies to help smokers reducing or stopping tobacco use should take into account their subgroup-specificity in order to better tailoring intervention and management of these populations that remain at higher risk of smoking-related morbidity and mortality. | ||||
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