Cigarette smoking is
increasingly recognized as an indicator for inferior adherence to
antiretroviral therapy (ART) among HIV-positive patients. Given the limited
body of work on this issue, we aimed to explore the relations between cigarette
smoking, nicotine dependence, and ART adherence in Vietnam.
A cross-sectional
study of 1050 HIV-positive people was conducted from January to September 2013
in Hanoi (the capital) and Nam Dinh (a rural city). Adherence to ART during the
last 30 days was measured by the 100-point visual analog scale (VAS). Smoking
history and nicotine dependence (Fagerstrom Test of Nicotine Dependence) were
self-reported by participants.
Multiple logistic regression was performed to
examine the association of current smoking and nicotine dependence with ART
nonadherence. Using the established VAS cut point of 95 to indicate adequate
adherence, the prevalence of ART nonadherence was 30.9%. Approximately 35.5% of
the sample reported current smoking. No association between smoking status and
ART nonadherence was found. However, participants with greater nicotine
dependence were more likely to be
nonadherent. Also, individuals who were female,
receiving ART in Nam Dinh, and currently feeling
anxiety had a higher likelihood of ART
nonadherence. Additionally, current smokers reporting current pain were more likely to be nonadherent. Conversely, protective
factors included living with a spouse/partner and
having more than a high school education.
Given the
high prevalence of suboptimal adherence and current smoking among HIV-positive
patients, screening for smoking status and nicotine dependence during ART
treatment may help to improve patients' adherence to medication. More efforts
should be targeted to women, patients with mental health problems, and ART
clinics in rural areas.
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By:
- 1a Department of Pharmacoeconomics & Pharmacoepidemiology , Hanoi University of Pharmacy , Hanoi , Vietnam.
- 2b Institute for Preventive Medicine and Public Health , Hanoi Medical University , Hanoi , Vietnam.
- 3c Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
- 4d The University of Texas Health Science Center at Houston , Houston , TX , USA.
- 5e Department of Family and Preventive Medicine , The University of Oklahoma Health Science Center , Oklahoma City , OK , USA.
- 6f Authority of HIV/AIDS Control, Ministry of Health , Hanoi , Vietnam.
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