Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA.
Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
AIDS Behav. 2024 Aug;28(8):2607-2618. doi: 10.1007/s10461-024-04363-6. Epub 2024 Jun 13.
U.S. Veterans and people living with HIV (PWH) experience higher rates of unhealthy alcohol and tobacco/nicotine use than non-Veterans and people without HIV (PWoH). Both groups are susceptible to adverse health outcomes associated with alcohol and tobacco/nicotine use. We explored awareness of alcohol- and tobacco/nicotine-related cancer and immune health risks among Veterans Health Administration (VA) patients with and without HIV. Among a sample of 41 (46% PWH; 73% male; 39% Black) purposively-selected VA patients receiving care 2020-2021 we conducted semi-structured interviews via telephone; interviews were recorded, transcribed and analyzed using a Rapid Assessment Process. Purposive selection was based on HIV status, alcohol and/or tobacco/nicotine use, and demographics. Among participants, 66% reported current smoking, and most screened positive for unhealthy alcohol use. Participants had high awareness of cancer and other health risks related to smoking but low awareness of synergistic risks and cancer risks associated with alcohol use despite awareness of a range of other alcohol-related risks. Awareness of alcohol and/or tobacco/nicotine's impacts on the immune system was variable. Findings did not distinctly differ between PWH and PWoH. Low awareness of alcohol-related cancer risk, risks of co-occurring use, and varying awareness of the impacts of alcohol and tobacco/nicotine on the immune system suggest a need for improved messaging regarding substance use-related cancer and immune risk. This may be especially important among PWH, for whom the prevalence and adverse effects of alcohol and tobacco use, and immune dysfunction are higher.
美国退伍军人和艾滋病毒感染者（HIV）比非退伍军人和非 HIV 感染者（PWoH）更倾向于不健康地使用酒精和烟草/尼古丁。这两个群体都容易受到与酒精和烟草/尼古丁使用相关的不良健康后果的影响。我们探讨了美国退伍军人事务部（VA）有和没有 HIV 的患者对酒精和烟草/尼古丁相关癌症和免疫健康风险的认识。在 2020-2021 年期间接受护理的 41 名（46%的 HIV 感染者；73%为男性；39%为黑人）有目的选择的 VA 患者的样本中，我们通过电话进行了半结构化访谈；使用快速评估过程对访谈进行记录、转录和分析。有目的的选择是基于 HIV 状况、酒精和/或烟草/尼古丁使用情况和人口统计学因素。在参与者中，66%报告目前吸烟，大多数人筛查出有不健康的饮酒行为。参与者对与吸烟有关的癌症和其他健康风险有很高的认识，但对酒精使用的协同风险和癌症风险认识较低，尽管对其他一系列与酒精有关的风险有一定的认识。对酒精和/或烟草/尼古丁对免疫系统的影响的认识是不同的。在 HIV 感染者和 PWoH 之间，发现没有明显的区别。对酒精相关癌症风险、共同发生使用的风险以及对酒精和烟草/尼古丁对免疫系统的影响的认识程度不同，这表明需要改进关于物质使用相关癌症和免疫风险的信息传递。这在 HIV 感染者中可能尤为重要，因为他们的酒精和烟草使用的流行率和不良影响以及免疫功能障碍更高。
