Alcohol, illicit drugs and socioeconomic factors are associated with smoking in people living with HIV/AIDS in Recife, Brazil
M.F.P.M. Albuquerque1, J.D.L. Batista1, D.B. Miranda-Filho2, H.R. Lacerda3, A.P. Silva4, R.A.A. Ximenes5, GRUPO AIDS PE
1Centro de Pesquisas Aggeu Magalhães / Fundação Oswaldo Cruz, Saúde Pública, Recife, Brazil, 2Universidade de Pernambuco, Doenças Infecciosas, Recife, Brazil, 3Universidade de Federal de Pernambuco, Medicina Tropical, Recife, Brazil, 4Hospital Correia Picanço, Ambulatorio HIV/AIDS, Recife, Brazil, 5Universidade Federal de Pernambuco, Medicina Tropical, Recife, Brazil
Background: Cigarette smoking is more prevalent in people with HIV than in the general population and is associated with death from cardiovascular disease and cancer in HIV/AIDS patients. The objective of this study was to estimate the prevalence of smoking, overall and by sex and factors associated with it, with special emphasis on the use of alcohol and illicit drugs.
Methods: This is a case-control study nested in a cohort of patients with HIV/AIDS attending two health service referral centers in Recife, Northeast region of Brazil, between January/2007 and October/2009. Individuals were considered to be smokers if they currently smoked or had quit smoking for six months or less, former smokers were those who used to smoke or had given up more than six months previously. Heavy smoking was deemed to be >10 cigarettes/day.
Results: The prevalence of smoking in the 1,815 patients studied was 28.9% [22.9% (157/685) in women and 32.6% (368/1130) in men]. A linear association was found between the levels of drug use and smoking for each drug studied, both among men: marijuana (linear trend chi2=126.7; p=0.000); crack (linear trend chi2=37.0; p=0.000); cocaine (linear trend chi2=29.7; p=0.000) and women: marijuana (linear trend chi2=39.2; p=0.000); crack (linear trend chi2=7.1;p=0.000); cocaine (linear trend chi2=8.7; p=0.003). The multivariate analysis showed that smoking among men is independently associated with age ≥ 50 years; heavy drinking; use of marijuana and crack; monthly family income below two minimum wages. Among women, not being married; living alone and the use of marijuana remained associated with smoking in the final multivariate model.
Conclusions: Individuals with HIV/AIDS are gradually getting more chronic diseases like cancer and cardiovascular disease, for which smoking is one of the most important risk factors. Action to prevent these diseases should include the treatment of smoking, alcohol and illicit drug use.
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