台州市男性HIV阳性者和HIV阴性者吸烟率及其影响因素的比较

Comparison of prevalence and correlates of smoking between males with and without HIV-infection in Taizhou City

目的比较台州市男性人类免疫缺陷病毒(human immunodeficiency virus, HIV)阳性者和HIV阴性者吸烟率并分析其影响因素,为台州市HIV阳性者有针对的制定和实施控烟措施提供依据。方法基于"HIV与衰老相关疾病前瞻性队列研究"的基线数据,收集人口学、吸烟相关特征等信息。最终纳入分析3 785名男性研究对象,应用SAS 9.4软件进行统计分析。结果男性HIV阳性者当前吸烟率为33.9%(95%CI:31.4%~36.5%),低于HIV阴性者(46.3%,95%CI:44.3%~48.3%);男性HIV阳性者以前吸烟率为14.1%(95%CI:12.3%~16.1%)略高于HIV阴性者(12.5%,95%CI:11.2%~13.9%),差异有统计学意义(χ~2=56.81,P<0.001)。男性HIV阳性者中,知晓感染后戒烟率为23.7%。使用多因素二分类Logistic回归模型分析显示,相较HIV阴性者,HIV阳性者当前吸烟的影响因素除职业、体重指数(body mass index,BMI)、日常锻炼以外,还包含年龄(40~岁,OR=1.87,95%CI:1.28~2.74,P=0.001;≥50岁,OR=2.30,95%CI:1.56~3.39,P<0.001)、同性传播途径(OR=0.45,95%CI:0.35~0.59,P<0.001)。结论台州市男性HIV阳性者目前吸烟状况仍然较普遍,且知晓HIV感染后曾尝试戒烟率较低。可通过加强男性HIV阳性者戒烟意识并结合影响当前吸烟的因素采取有针对性的措施控烟。

Objective To analyze and compare the prevalence and correlates of smoking among HIV-infected and HIV-uninfected men in Taizhou City, and to provide this for the development and implementation of tobacco control measures for HIV-infected population. Methods We used baseline data from the ongoing prospective cohort study of Comparative HIV and Aging Research in Taizhou(CHART), China. 3 785 men were included in analysis. We collected basic characteristics, smoking behaviors, and so on. All analysis were performed using SAS 9.3. Results Compared to HIV-uninfected men, the prevalence of current smoking was lower(33.9%, 95% CI: 31.4%-36.5% versus 44.6%, 95%CI: 44.3%-48.3%) but prevalence of previous smoking was higher(14.1%, 95% CI: 12.3%-16.1% versus 12.5%, 95% CI: 11.2%-13.9%;χ~2 =56.81, P<0.001). Among male HIV-positive people, the rate of smoking cessation after infection was 23.7%. Multivariate multinomial Logistic regression analysis showed that compared to HIV-uninfected men, in addition to occupation, body mass index and regular exercise that were associated with current smoking, older age(40-50 years, OR=1.87, 95%CI: 1.28-2.74, P=0.001;≥50 years, OR=2.30, 95% CI: 1.56-3.39, P<0.001) and homosexual transmission(OR=0.45, 95% CI: 0.35-0.59, P<0.001) were also associated with current smoking among HIV-infected men. Conclusions Cigarette smoking remains highly prevalent among HIV-infected men in Taizhou City, but with low self-reported smoking cessation rate even after knowing their HIV-positive status. Targeted measures can be taken to control tobacco by strengthening the awareness of HIV-positive persons to quit smoking and combining the factors affecting current smoking among HIV-infected population.