Yang Shanyin, Huang Jiegang, Ye Li, Lin Jianyan, Xie Zhiman, Guo Baodong, Li Yanjun, Liang Bingyu, Zheng Zhigang, Lunze Karsten, Abdullah Abu S, Liang Hao, Quintiliani Lisa M
Section of General Internal Medicine, Boston Medical Center, Boston, MA, United States.
Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
JMIR Form Res. 2022 Oct 12;6(10):e35923. doi: 10.2196/35923.
China, where half of the adult male population smoke tobacco, has one of the highest global burdens of smoking. Smoking rates are even higher among people with HIV. People with HIV can be affected by smoking in multiple ways, including more severe HIV-related symptoms and worse antiretroviral therapy treatment outcomes. However, smoking cessation services targeted for people with HIV are not routinely integrated into HIV care in China. Given the widespread mobile phone ownership, an exploration of factors related to smoking among people with HIV in China who smoke could inform the design and implementation of mobile smoking cessation interventions that target the needs of this vulnerable population.
This study aims to explore the perspectives of smoking, barriers and facilitators to quitting, and perceptions related to a smoking cessation intervention delivered through behavioral counseling sessions and brief daily messenger service (WeChat)-delivered messages.
We recruited people with HIV from the People's 4th Hospital of Nanning, Guangxi, China, and conducted semistructured face-to-face interviews. All interviews were audio-recorded, transcribed verbatim in Chinese, and translated into English for data analysis. We conducted a thematic analysis using a codebook, which was guided by a team-based consensus approach to identify 5 main themes. We also explored themes according to the demographic groups.
A total of 24 participants were enrolled in the study. The mean age was 37.2 (SD=13.5) years. The participants had lived with HIV for a mean of 2.4 years. The majority were male (18/24, 75%) and lived in urban or metropolitan settings (19/24, 79%). We identified five main themes: variable knowledge of the harms of smoking, both related and unrelated to HIV; willpower perceived as the primary quitting strategy; a duality of the effect of social factors on quitting; perceptions about optimal features of the smoking cessation intervention (eg, messages should be brief and most frequent during the first few weeks); and the largely negative impact of their HIV diagnosis on smoking behaviors. In addition, some themes differed according to participant demographic characteristics such as age, sex, and education level.
We identified barriers to and facilitators of smoking cessation among people with HIV in China by conducting semistructured qualitative interviews. Owing to the adverse impact of smoking on HIV outcomes, targeting cessation interventions to the unique needs and preferences of people with HIV in China may be needed to increase the effectiveness of future interventions. A pilot clinical trial will be conducted in the future to evaluate this behavioral counseling and brief daily messenger service (WeChat)-delivered messages approach among people with HIV who smoke in China.
在中国，成年男性吸烟率达一半，是全球吸烟负担最重的国家之一。艾滋病毒感染者中的吸烟率更高。艾滋病毒感染者会在多方面受到吸烟影响，包括出现更严重的与艾滋病毒相关的症状以及抗逆转录病毒治疗效果更差。然而，在中国，针对艾滋病毒感染者的戒烟服务并未常规纳入艾滋病毒护理中。鉴于手机普及率高，探索中国吸烟的艾滋病毒感染者的吸烟相关因素，可为针对这一弱势群体需求的移动戒烟干预措施的设计和实施提供参考。
本研究旨在探讨吸烟的观点、戒烟的障碍和促进因素，以及对通过行为咨询课程和每日简短信息服务（微信）发送的信息进行的戒烟干预措施的看法。
我们从中国广西南宁第四人民医院招募艾滋病毒感染者，并进行半结构化面对面访谈。所有访谈都进行了录音，逐字记录为中文，并翻译成英文进行数据分析。我们使用一个编码手册进行主题分析，该手册以基于团队的共识方法为指导，以确定5个主要主题。我们还根据人口统计学分组探讨了主题。
共有24名参与者纳入研究。平均年龄为37.2（标准差 = 13.5）岁。参与者感染艾滋病毒的平均时间为2.4年。大多数为男性（18/24，75%），居住在城市或大都市地区（19/24，79%）。我们确定了5个主要主题：对吸烟危害的认识不一，有些与艾滋病毒有关，有些无关；意志力被视为主要的戒烟策略；社会因素对戒烟的影响具有双重性；对戒烟干预措施最佳特征的看法（例如，信息应简短，在最初几周内频率最高）；以及艾滋病毒诊断对其吸烟行为的主要负面影响。此外，一些主题因参与者的年龄、性别和教育水平等人口统计学特征而异。
我们通过进行半结构化定性访谈，确定了中国艾滋病毒感染者戒烟的障碍和促进因素。由于吸烟对艾滋病毒治疗结果有不利影响，可能需要针对中国艾滋病毒感染者的独特需求和偏好开展戒烟干预措施，以提高未来干预措施的有效性。未来将开展一项试点临床试验，以评估这种行为咨询和每日简短信息服务（微信）发送信息的方法对中国吸烟的艾滋病毒感染者的效果。
