Balfour Louise, Wiebe Stephanie A, Cameron William D, Sandre Daniella, Pipe Andrew, Cooper Curtis, Angel Jonathan, Garber Gary, Holly Crystal, Dalgleish Tracy L, Tasca Giorgio A, MacPherson Paul A
a Department of Psychology , The Ottawa Hospital , Ottawa , ON , Canada.
b Department of Psychology , The University of Ottawa , Ottawa , ON , Canada.
AIDS Care. 2017 Jan;29(1):24-31. doi: 10.1080/09540121.2016.1201195. Epub 2016 Jul 19.
Cardiovascular disease (CVD) rates among people living with HIV/AIDS (PHAs) are high. Rates of cigarette smoking, a leading contributor to CVD among PHAs, are 40-70% (2-3 times higher than the general population). Furthermore, PHAs have high rates of depression (40-60%), a risk factor for smoking cessation relapse. The current pilot study examined the effectiveness of a specifically tailored 5-session smoking cessation counselling programme for PHAs, which addressed depression, in combination with Nicotine Replacement Therapy (NRT) in a cohort of PHA smokers (n = 50). At 6-month follow-up, 28% of participants demonstrated biochemically verified abstinence from smoking. This result compares favourably to other quit-smoking intervention studies, particularly given the high percentage of HIV+ smokers with depression. At study baseline, 52% of HIV+ smokers scored above the clinical cut-off for depression on the Centre for Epidemiological Studies - Depression (CES-D) scale. HIV+ smokers with depression at study baseline demonstrated quantitatively lower depression at 6-month follow-up with a large effect size (d = 1), though it did not reach statistical significance (p = .058). Furthermore, those with depression were no more likely to relapse than those without depression (p = .33), suggesting that our counselling programme adequately addressed this significant barrier to smoking cessation among PHAs. Our pilot study indicates the importance of tailored programmes to help PHAs quit smoking, the significance of addressing depressive symptoms, and the need for tailored counselling programmes to enhance quit rates among PHAs.
感染艾滋病毒/艾滋病（HIV/AIDS）者（PHA）的心血管疾病（CVD）发病率很高。吸烟率是PHA中CVD的主要促成因素，为40%-70%（比普通人群高2-3倍）。此外，PHA的抑郁症发病率很高（40%-60%），这是戒烟复发的一个风险因素。当前的试点研究检验了一项专门为PHA量身定制的、包含5节课程的戒烟咨询计划的有效性，该计划针对抑郁症，并结合尼古丁替代疗法（NRT），应用于一组PHA吸烟者（n = 50）。在6个月的随访中，28%的参与者经生化验证成功戒烟。这一结果与其他戒烟干预研究相比很有利，尤其是考虑到感染艾滋病毒的吸烟者中抑郁症患者的比例很高。在研究基线时，52%的感染艾滋病毒的吸烟者在流行病学研究中心抑郁量表（CES-D）上的得分高于抑郁症临床临界值。研究基线时患有抑郁症的感染艾滋病毒的吸烟者在6个月随访时抑郁程度在数量上有所降低，效应量较大（d = 1），尽管未达到统计学显著性（p = 0.058）。此外，患有抑郁症的人复发的可能性并不比没有抑郁症的人高（p = 0.33），这表明我们的咨询计划充分解决了PHA戒烟的这一重大障碍。我们的试点研究表明了量身定制计划对帮助PHA戒烟的重要性、解决抑郁症状的意义，以及需要量身定制咨询计划以提高PHA的戒烟率。
