Barcelona 2013
Barcelona 2013
Abstract book - Abstract - 403
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Conference Details
International Committee
Plenary Speakers
Presenting Speakers
Scientific Committee
Abstract #403  -  Drugs and Alcohol
  22.6: Drugs and Alcohol (Parallel) on Monday @ 16.30-18.30 in Mirador Chaired by Sam Friedman,
Rosa Mansilla

  Presenting Author:   Ms Laure Tron - INSERM, France
  Additional Authors:  Dr. Patricia Solomon, Mr. Larry Baxter, Dr. Alan Casey, Mr. Will Chegwidden, Mr. Duncan MacLachlan, Dr. Joy MacDermid, Ms. Anne-Marie Tynan, Dr. Greg Robinson, Dr. Barry Trentham, Ms. Janet Wu, Ms. Elisse Zack,  
In the era of potent combination antiretroviral therapies, tobacco smoking is a major risk factor of comorbidity and premature mortality among people living with HIV. Higher rates of smoking have been consistently reported in HIV-infected people as compared to those HIV-uninfected. However, these rates are mostly based on studies restricted to specific subgroups of the HIV-infected population. Besides, most comparisons did not account for the specificities of HIV-infected people in terms of population subgroups (high prevalences of men who have sex with men [MSM] and injecting drug users [IDU]) and sociodemographic characteristics. The objective of the present study was to provide estimates of smoking rates in the various subgroups constituting the population living with HIV in France, and to adequately compare them to those reported in the general French population.
Method / Issue:
We used data from the ANRS-Vespa2 study, a cross-sectional survey conducted in 2011 among a national representative sample of 3022 HIV-infected hospital outpatients in France. Data collected included detailed information on participants? sociodemographic characteristics, substance use including tobacco smoking and injecting drug use, and sexual behaviors. Survey weights were applied to account for study design and non-participation, thus allowing providing estimates generalizable to the whole HIV-infected population followed at hospital in France. Direct standardization was used to estimate age, gender, geographic origin and education-standardized smoking rates among HIV-infected individuals, using the ?Baromètre Santé 2010? national health interview survey, conducted among a national representative sample of the French general population (N=27,653), as reference. Considering the low prevalences of IDU and MSM (<1.5%) in this population, standardized smoking rates were computed only for non-IDU non-MSM individuals. All analyses accounted for data weighting and were restricted to adults over 18.
Results / Comments:
The HIV-infected population was composed of 13.4% IDU, 36.7% non-IDU MSM and 49.9% non-IDU non-MSM. This latter group comprised a majority of women (57.8%) and of non-French natives (55.0%, of whom 86.2% originating from sub-Saharan Africa). Overall, 40.4% (95% confidence interval [95%CI]: 37.7%-43.0%) of HIV-infected individuals reported having never smoked or just tried, 37.6% (95%CI: 35.1%-40.0%) were current smokers and 22.1% (95%CI: 20.1%-24.0%) were past smokers. There were strong differences across the various subgroups of the HIV-infected population, notably low rates of never smokers and high rates of current smokers among IDU (3.5%, 95%CI: 1.6%-5.3% and 76.0%, 95%CI: 70.7%-81.4%, respectively) and, to a lesser extent, among non-IDU MSM (33.7%, 95%CI: 30.4%-37.0% and 41.8%, 95%CI: 38.2%-45.4%, respectively). In the general population, 36.7% were never smokers, 32.1% current smokers and 31.1% past smokers. Among HIV-infected non-IDU non-MSM individuals, the standardized rate of never smokers (34.5%, 95%CI: 30.0%-39.0%) did not differ from that in the general population while the rate of current smokers was higher (37.2%, 95%CI: 32.5%-41.8%) and the rate of past smokers tended to be lower (28.4%, 95%CI: 24.4%-32.3%).
Smoking is particularly frequent among HIV-infected IDU and MSM. Yet, our results suggest that smoking constitutes a major concern among HIV-infected non-IDU non-MSM as well. HIV infection might be associated with more difficulties to achieve and/or less promotion of smoking cessation.
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