Department of Pediatrics, 9967The University of Alabama, Birmingham, AL, USA.
Department of Psychiatry, 9967The University of Alabama, Birmingham, AL, USA.
J Int Assoc Provid AIDS Care. 2023 Jan-Dec;22:23259582231163125. doi: 10.1177/23259582231163125.
Youth with HIV (YWH) aged 18-24 are overburdened by tobacco, with half also using cannabis recreationally. Increasing tobacco cessation necessitates exploring providers' approaches to cessation. Grounded in social cognitive theory, we explored cognitive, socioenvironmental, and behavioral factors impacting providers' approaches to tobacco use among recreational cannabis users. Virtual interviews were conducted among healthcare providers caring for YWH in Washington (legalized cannabis), Massachusetts (legalized cannabis), and Alabama (cannabis not legal). Interviews were transcribed and analyzed via deductive and exploratory, thematic approaches using NVivo 12 Plus. Twelve providers participated; 80% were subspecialist physicians. All providers ( = 12) reported discussing tobacco use; none reported discussing tobacco use in conjunction with cannabis use. Identified themes included competing demands including cannabis co-use, prioritization of social determinants of health, and need for youth-tailored tools. YWH disproportionately use tobacco and recreational cannabis. Optimizing clinical visits to identify opportunities to address tobacco is crucial.
18-24 岁的感染艾滋病毒的青年（YWH）深受烟草的困扰，其中一半人还经常吸食大麻。为了增加戒烟人数，有必要探索提供戒烟服务的人员对经常吸食大麻的人采取的戒烟方法。本研究以社会认知理论为基础，探讨了认知、社会环境和行为因素对提供者对经常吸食大麻者采取的烟草使用方法的影响。在华盛顿（大麻合法化）、马萨诸塞州（大麻合法化）和阿拉巴马州（大麻非法）为 YWH 提供医疗服务的医护人员中进行了虚拟访谈。访谈记录被转录，并使用 NVivo 12 Plus 通过演绎和探索性主题方法进行了分析。共有 12 名提供者参与，其中 80%为专科医生。所有提供者（n=12）都报告了讨论烟草使用的情况，但没有报告讨论烟草使用与大麻使用之间的联系。确定的主题包括相互竞争的需求，包括大麻的共同使用、对健康决定因素的优先排序，以及需要为年轻人量身定制的工具。YWH 不成比例地使用烟草和娱乐性大麻。优化临床访问以确定解决烟草问题的机会至关重要。
