Cigarette smoking among HIV patients receiving antiretroviral therapy in Vietnam

Cigarette smoking among people living with HIV/AIDS (PLWHA) is becoming a significant public health concern. Viet Nam is a developing country confronting detrimental impacts from the intersection of cigarette smoking and HIV epidemics. To our knowledge, there has been no research on cigarette smoking among PLWHA in Vietnam. Therefore, this study is among the first to address the issue in the country. The purposes of this dissertation were to: 1) examine cigarette smoking prevalence, nicotine dependence, and associated factors among PLWHA in Vietnam, 2) explore effects of cigarette smoking and nicotine dependence on antiretroviral therapy (ART) adherence, and 3) examine motivation to quit smoking and its correlates among HIV-positive smokers. ^ Data used in our analyses were from the cross-sectional survey \u222013 HIV Services Users Survey\u22. This survey was conducted from January to September 2013, among 1133 HIV-positive patients at eight ART clinics in Hanoi (the capital) and Nam Dinh (a rural city) in the northern region in Vietnam. Multivariate linear and logistic regression analyses were performed to identify factors associated with continuous and binary outcomes, respectively. ^ The proportions of current, former, and never smokers in the sample were 36.1%, 9.5%, and 54.4%, respectively. The prevalence of current smoking was much higher in males (59.7%) than females (2.6%). Alcohol consumption and lifetime drug use were associated with both current smoking status and greater nicotine dependence. Additionally, we observed a high prevalence of ART nonadherence (30.9%) in the overall sample. No association between smoking status and ART nonadherence was found. However, participants with greater nicotine dependence were more likely to be nonadherent. Finally, a substantial proportion of HIV-positive smokers were motivated to quit (59.4%). Among motivated smokers, 50.2% had attempted to quit in the past year and 66.3% planned to quit in the next 3 months. Barriers for quitting were current use of Methadone, binge drinking, and lifetime drug use. ^ In conclusion, screening for smoking and providing smoking cessation supports should be integrated into HIV care to reduce adverse health outcomes, particularly to improve ART adherence among PLWHA in Vietnam. Cessation interventions should be tailored to meet specific needs for different patient subgroups.