Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
Department of Health Promotion, Education, and Behavior, University of South Carolina System, Columbia, South Carolina, USA.
BMJ Open. 2021 Sep 6;11(9):e054903. doi: 10.1136/bmjopen-2021-054903.
People living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6-13 times more likely to die from lung cancer than AIDS-related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA.
Women enrolled in an ongoing longitudinal cohort study from 2013 to 2015.
Nine participating sites across the USA.
2553 participants enrolled in the Food Insecurity Sub-Study of the Women's Interagency HIV Study, a multisite cohort study of US women living with HIV and demographically similar HIV-seronegative women.
Current cigarette smoking status and intensity were self-reported. We used cross-sectional and longitudinal logistic and Tobit regressions to assess associations of food security status and changes in food security status with smoking status and intensity.
The median age was 48. Most respondents were African-American/black (72%) and living with HIV (71%). Over half had annual incomes ≤US$12 000 (52%). Food insecurity (44%) and cigarette smoking (42%) were prevalent. In analyses adjusting for common sociodemographic characteristics, all categories of food insecurity were associated with greater odds of current smoking compared with food-secure women. Changes in food insecurity were also associated with increased odds of smoking. Any food insecurity was associated with higher smoking intensity.
Food insecurity over time was associated with smoking in this cohort of predominantly low-income women of colour living with or at risk of HIV. Integrating alleviation of food insecurity into smoking cessation programmes may be an effective method to reduce the smoking prevalence and disproportionate lung cancer mortality rate particularly among PLHIV.
美国的艾滋病毒感染者（PLHIV），尤其是女性，比一般人群更普遍面临粮食不安全问题。PLHIV 中吸烟的情况很常见（42%），PLHIV 死于肺癌的可能性比艾滋病相关原因高 6-13 倍。本研究旨在调查粮食安全状况与美国一个以有色人种为主的低收入妇女队列中有无 HIV 感染的妇女的吸烟状况和严重程度之间的关联。
2013 年至 2015 年期间，参加一项正在进行的纵向队列研究的妇女。
美国九个参与地点。
参加妇女机构间艾滋病毒研究的粮食不安全子研究的 2553 名参与者，这是一项针对美国艾滋病毒感染者和具有相似艾滋病毒血清学阴性的女性的多地点队列研究。
目前的吸烟状况和吸烟强度是自我报告的。我们使用横断面和纵向逻辑回归和 Tobit 回归来评估粮食安全状况和粮食安全状况变化与吸烟状况和吸烟强度的关联。
中位年龄为 48 岁。大多数受访者是非洲裔/黑人（72%），并感染了 HIV（71%）。超过一半的人年收入≤12000 美元（52%）。粮食不安全（44%）和吸烟（42%）很普遍。在调整常见社会人口特征后，与粮食安全的女性相比，所有类别的粮食不安全都与更高的当前吸烟几率相关。粮食不安全状况的变化也与吸烟几率的增加相关。任何粮食不安全都与更高的吸烟强度相关。
在这个以有色人种为主的低收入妇女队列中，随着时间的推移，粮食不安全与吸烟有关，他们或有 HIV 感染风险。将缓解粮食不安全纳入戒烟计划可能是减少吸烟流行率和特别在 PLHIV 中降低不成比例的肺癌死亡率的有效方法。
