Smoking cessation for persons living with HIV: a review of currently available interventions.
ABSTRACT Smoking among persons living with HIV infection (PLWH) is estimated to be two to three times greater than the general population. Data suggest that cigarette smoking is more common among PLWH because of factors such as lower socioeconomic status, previous or concurrent illicit drug and alcohol use, age, education level, and concurrent depressive symptoms. Cigarette smoking in HIV-infected individuals has been associated with higher risk of certain cancers, infections, and a decrease in response to antiretroviral therapy. Recent guidelines from the U.S. Public Health Service have recommended the use of counseling and pharmacologic therapies for all patients interested in quitting smoking. It is critical for clinicians caring for PLWH to be familiar with these modalities. This article provides an overview of currently available interventions for smoking cessation, reviews considerations for patients with HIV, and discusses clinical implications for nurses and advanced practice clinicians.
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ABSTRACT: Low cost, effective interventions are needed to deal with the major global burden of HIV/AIDS. Telephone consultation offers the potential to improve health of people living with HIV/AIDS cost-effectively and to reduce the burden on affected people and health systems. The aim of this systematic review was to assess the effectiveness of telephone consultation for HIV/AIDS care. We undertook a comprehensive search of peer-reviewed and grey literature. Two authors independently screened citations, extracted data and assessed the quality of randomized controlled trials which compared telephone interventions with control groups for HIV/AIDS care. Telephone interventions were voice calls with landlines or mobile phones. We present a narrative overview of the results as the obtained trials were highly heterogeneous in design and therefore the data could not be pooled for statistical analysis. The search yielded 3321 citations. Of these, nine studies involving 1162 participants met the inclusion criteria. The telephone was used for giving HIV test results (one trial) and for delivering behavioural interventions aimed at improving mental health (four trials), reducing sexual transmission risk (one trial), improving medication adherence (two trials) and smoking cessation (one trial). Limited effectiveness of the intervention was found in the trial giving HIV test results, in one trial supporting medication adherence and in one trial for smoking cessation by telephone. We found some evidence of the benefits of interventions delivered by telephone for the health of people living with HIV or at risk of HIV. However, only limited conclusions can be drawn as we only found nine studies for five different interventions and they mainly took place in the United States. Nevertheless, given the high penetration of low-cost mobile phones in countries with high HIV endemicity, more evidence is needed on how telephone consultation can aid in the delivery of HIV prevention, treatment and care.PLoS ONE 05/2012; 7(5):e36105. DOI:10.1371/journal.pone.0036105 · 3.53 Impact Factor
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ABSTRACT: Cigarette smoking is endemic among many populations, but is especially prevalent among people living with HIV, and is consequently associated with a variety of types of morbidity as well as mortality. Despite this knowledge, relatively little research has been conducted among smokers living with HIV. Extant research has focused on examining individual-level characteristics associated with smoking behaviors, to the neglect of examining social-level factors. This manuscript represents a critical literature review of the intersecting research fields of HIV and cigarette smoking. Topics considered within this review include: morbidity, mortality, as well as treatment and medication adherence outcomes; individual- and social-level characteristics associated with various smoking behaviors; evidence-based smoking cessation interventions; and findings from cessation interventions among smokers living with HIV. Additionally, gaps in the existing literature, as well as directions for future research were identified and discussed.Addiction Research and Theory 05/2014; 23(1). DOI:10.3109/16066359.2014.920013 · 1.03 Impact Factor
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ABSTRACT: Tobacco smoking remains a prevalent behavior in people living with HIV infection (PLWHs) and is associated with impaired immune functioning, increased cardiovascular risk, and decreased response to antiretroviral therapy. This review presents a critique and synthesis of evidence on effective smoking-cessation interventions for PLWHs. A comprehensive search identified nine peer-reviewed intervention studies published between 1989 and 2012. The highest likelihood of smoking cessation (range of odds ratios 4.33-5.6) were in two randomized controlled trial interventions using cell phone technology. Clinically significant reductions in systolic blood pressure, weight gain, and increased CD(4+) T-cell count were reported in participants who ceased smoking in three of the nine studies. Overall, multistrategy smoking-cessation interventions, delivered over multiple sessions, were effective. However, the most effective interventions were tailored to the unique individual needs of PLWHs, including assessment of and intervention for polysubstance abuse and mental health issues, as well as the inclusion of access-promoting elements.The Journal of the Association of Nurses in AIDS Care: JANAC 07/2013; DOI:10.1016/j.jana.2013.04.005 · 1.23 Impact Factor