Weinberger Andrea H, Smith Philip H, Funk Allison P, Rabin Shayna, Shuter Jonathan
*Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY; †Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY; ‡Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY; §Department of Psychology, Hofstra University, Hempstead, NY; ‖Stern College for Women, Yeshiva University, New York, NY; and ¶AIDS Center and Division of Infectious Diseases, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY.
J Acquir Immune Defic Syndr. 2017 Apr 1;74(4):439-453. doi: 10.1097/QAI.0000000000001279.
Persons living with HIV/AIDS (PLWH) smoke at higher rates than other adults and experience HIV-related and non-HIV-related adverse smoking consequences. This study conducted a systematic review to synthesize current knowledge about sex differences in smoking behaviors among PLWH.
Over 3000 abstracts from MEDLINE were reviewed and 79 publications met all the review inclusion criteria (ie, reported data on smoking behaviors for PLWH by sex). Sufficient data were available to conduct a meta-analysis for one smoking variable: current smoking prevalence.
Across studies (n = 51), the meta-analytic prevalence of current smoking among female PLWH was 36.3% (95% confidence interval [CI]: 28.0% to 45.4%) and male PLWH was 50.3% (95% CI: 44.4% to 56.2%; meta-analytic odds ratio = 1.78, 95% CI: 1.29 to 2.45). When analyses were repeated just on the US studies (n = 23), the prevalence of current smoking was not significantly different for female PLWH (55.1%, 95% CI: 47.6% to 62.5%) compared with male PLWH (55.5%, 95% CI: 48.2% to 62.5%; meta-analytic odds ratio = 1.04, 95% CI: 0.86 to 1.26). Few studies reported data by sex for other smoking variables (eg, quit attempts, noncigarette tobacco product use) and results for many variables were mixed.
Unlike the general US population, there was no difference in smoking prevalence for female versus male PLWH (both >50%) indicating that HIV infection status was associated with a greater relative increase in smoking for women than men. More research is needed in all areas of smoking behavior of PLWH to understand similarities and differences by sex to provide the best interventions to reduce the high smoking prevalence for all sexes.
感染艾滋病毒/艾滋病的人群（PLWH）吸烟率高于其他成年人，且会经历与艾滋病毒相关及非艾滋病毒相关的不良吸烟后果。本研究进行了一项系统综述，以综合当前关于PLWH吸烟行为性别差异的知识。
对来自MEDLINE的3000多篇摘要进行了审查，79篇出版物符合所有综述纳入标准（即按性别报告了PLWH吸烟行为的数据）。有足够的数据可对一个吸烟变量进行荟萃分析：当前吸烟流行率。
在各项研究（n = 51）中，女性PLWH当前吸烟的荟萃分析流行率为36.3%（95%置信区间[CI]：28.0%至45.4%），男性PLWH为50.3%（95%CI：44.4%至56.2%；荟萃分析优势比 = 1.78，95%CI：1.29至2.45）。仅对美国的研究（n = 23）重复进行分析时，女性PLWH当前吸烟流行率（55.1%，95%CI：47.6%至62.5%）与男性PLWH（55.5%，95%CI：48.2%至62.5%；荟萃分析优势比 = 1.04，95%CI：0.86至1.26）相比无显著差异。很少有研究按性别报告其他吸烟变量（如戒烟尝试、非香烟烟草制品使用）的数据，且许多变量的结果参差不齐。
与美国普通人群不同，女性与男性PLWH的吸烟流行率没有差异（均>50%），这表明艾滋病毒感染状况与女性吸烟相对男性吸烟的更大幅度增加有关。需要对PLWH吸烟行为的所有领域进行更多研究，以了解性别方面的异同，从而提供最佳干预措施，降低所有性别的高吸烟流行率。
