Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.
Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.
Nicotine Tob Res. 2019 Jul 17;21(8):1093-1102. doi: 10.1093/ntr/nty176.
Having HIV/AIDS has been associated with a higher prevalence of smoking. Moreover, evidence suggests that people with HIV/AIDS who smoke have poorer treatment and survival outcomes. The HIV-smoking relationship is understudied in sub-Saharan Africa, where tobacco use patterns and HIV prevalence differ greatly from other world regions.
Cross-sectional data from the Demographic Health Surveys and AIDS Indicator Surveys, representing 25 sub-Saharan African countries, were pooled for analysis (n = 286850). The association between cigarette smoking and HIV status was analyzed through hierarchical logistic regression models. This study also examined the relationship between smokeless tobacco (SLT) use and HIV status.
Smoking prevalence was significantly higher among men who had HIV/AIDS than among men who did not (25.90% vs 16.09%; p < .0001), as was smoking prevalence among women who had HIV/AIDS compared with women who did not (1.15% vs 0.73%; p < .001). Multivariate logistic regression revealed that the odds of smoking among people who had HIV/AIDS was 1.12 times greater than among people who did not when adjusting for socioeconomic, demographic, and sexual risk factors (adjusted OR = 1.12, 95% CI = 1.04% to 1.21%; p < .001). Similarly, multivariate logistic regression revealed that HIV-positive individuals were 34% more likely to use SLT than HIV-negative individuals (adjusted OR = 1.34, 95% CI = 1.17% to 1.53%).
Having HIV was associated with a greater likelihood of smoking cigarettes as well as with using SLT in sub-Saharan Africa. These tobacco use modalities were also associated with male sex and lower socioeconomic status.
This study shows that in sub-Saharan Africa, as in more studied world regions, having HIV/AIDS is associated with a higher likelihood of smoking cigarettes when adjusting for demographic, socioeconomic, and sexual risk factors. This study also supports the literature stating that cigarette smoking is inversely associated with socioeconomic status, as evidenced by higher smoking prevalence among poorer individuals, less educated individuals, and manual and agricultural laborers.
患有艾滋病病毒/艾滋病（HIV/AIDS）与更高的吸烟率有关。此外，有证据表明，感染 HIV/AIDS 的吸烟者治疗效果和生存结果更差。在撒哈拉以南非洲，吸烟与 HIV 的关系研究不足，因为该地区的烟草使用模式和 HIV 流行率与其他世界地区有很大不同。
对代表 25 个撒哈拉以南非洲国家的人口健康调查和艾滋病指标调查的横断面数据进行了汇总分析（n=286850）。通过分层逻辑回归模型分析了吸烟与 HIV 状态之间的关系。本研究还检查了咀嚼烟草（SLT）使用与 HIV 状态之间的关系。
与未感染 HIV/AIDS 的男性相比，感染 HIV/AIDS 的男性吸烟率明显更高（25.90%比 16.09%；p<.0001），感染 HIV/AIDS 的女性吸烟率也高于未感染 HIV/AIDS 的女性（1.15%比 0.73%；p<.001）。多变量逻辑回归显示，在调整了社会经济、人口统计学和性行为危险因素后，感染 HIV/AIDS 的人吸烟的可能性比未感染 HIV/AIDS 的人高 1.12 倍（调整后的比值比[OR]为 1.12，95%置信区间[CI]为 1.04%至 1.21%；p<.001）。同样，多变量逻辑回归显示，HIV 阳性个体使用 SLT 的可能性比 HIV 阴性个体高 34%（调整后的 OR=1.34，95%CI=1.17%至 1.53%）。
在撒哈拉以南非洲，感染 HIV 与更有可能吸烟以及使用 SLT 有关。这些烟草使用方式也与男性性别和较低的社会经济地位有关。
本研究表明，在撒哈拉以南非洲，与在更有研究的世界地区一样，在调整人口统计学、社会经济和性行为危险因素后，感染 HIV/AIDS 与更高的吸烟率有关。本研究还支持了文献中关于吸烟与社会经济地位呈负相关的说法，因为在较贫困、受教育程度较低、从事体力劳动和农业劳动的人群中，吸烟率更高。
