The 13th World Conference on Tobacco OR Health

Objective: In developed countries a disproportionate number of HIV-infected adults smoke. The association between HIV and smoking in a high HIV prevalence urban workforce was investigated.

Methods: Demographic and smoking data collected including questions concerning current and past tobacco consumption. Smokers defined by lifetime consumption of at least 20 cigarettes or pipe tobacco. Current smokers defined as those who had smoked on at least one occasion in the previous month. Confidential plasma specimens were tested for HIV antibodies using Abbott Determine™ (Abbot, Wiesbaden, Germany)

Results: 4902 workers consented to HIV testing, 88% male, median age 34 years. HIV prevalence was 19%, current smokers 17%, and 7% former smokers. Significantly more of the HIV-positives were smokers (33%) than the HIV-negatives (22%) (OR 1.4, 95% CI, 1.2-1.6). Potential for confounding with age shown, as both smokers, (median age 44 yrs), and HIV-positive, (median age 38 yrs), older than average. HIV infection, male sex, older age and being married, shown as independent risk factors for being a smoker. Previous history of TB treatment (adjusted OR 0.7; 95% CI, 0.6-0.9) and higher level of education (adjusted OR, 0.9; 95% CI, 0.4-0.7) associated with low risk of being a current smoker. Results demonstrate that there are shared risk factors for being both a smoker and being HIV-positive. This possibly reflects “risky” personality traits associated with multiple risk taking behaviours plus age and sex. With 33% of HIV-positives being smokers, smoking maybe an important and preventable co-factor increasing the risk of respiratory illnesses among HIV-positives.