桂林市抗病毒治疗的男性HIV/AIDS患者戒烟调查

Investigation of smoking cessation among male HIV/AIDS patients with cART in Guilin City

目的 调查广西桂林市cART中男性HIV/AIDS患者的戒烟状况,包括戒烟成功率及其相关因素。方法采用横断面设计,于2022年6-8月在桂林市第三人民医院感染科招募cART中的男性HIV/AIDS患者参与问卷调查,收集其社会人口学资料及一般特征、戒烟状况、临床特征以及抑郁、焦虑、压力、社会支持和应对策略等社会心理特征,采用二分类非条件Logistic回归模型分析成功戒烟的相关因素。结果 490名有效样本中,31.6%(155人)在cART中成功戒烟。多因素分析结果显示,受教育程度为大学本科及以上(aOR=1.97,95%CI:1.24~3.15)、CD4细胞计数>350个/μL(aOR=2.20,95%CI:1.36~3.58)、cART持续时间≤3年(aOR=2.09,95%CI:1.30~3.34)、没有其他慢性疾病(aOR=2.23,95%CI:1.27~3.92)、没有抑郁症状(aOR=2.26,95%CI:1.34~3.80)、压力正常(aOR=2.50,95%CI:1.46~4.29)、应对策略积极(aOR=2.56,95%CI:1.42~4.63)、较高的社会支持(社会支持中等aOR=2.90,95%CI:1.54~5.48;高社会支持aOR=3.69,95%CI:1.83~7.41)、没有自杀意念(aOR=1.72,95%CI:1.05~2.83)的男性HIV/AIDS患者戒烟成功的比例更高。结论 cART中男性HIV/AIDS患者的戒烟成功率较低,在戒烟干预中,应特别关注吸烟者的健康状况,尤其是教育程度较低者,及时提供专业心理咨询和戒烟指导,增强其健康意识,并定期监测其疾病进展,提高其社会支持水平,构建结合生物、心理和社会因素的综合戒烟干预模式。HIV感染诊断是启动戒烟干预措施的关键时机,亟需将戒烟策略纳入HIV感染者的护理服务。

Objective To investigate the smoking cessation status among male HIV/AIDS patients receiving combined antiretroviral therapy(cART)in Guilin,Guangxi,including the smoking cessation success rate and its associated factors.Methods A cross-sectional study was conducted from June to August 2022 at the infectious disease department of the Third People's Hospital of Guilin.Male HIV/AIDS patients receiving cART were recruited to participate in a questionnaire survey.Data on demographic characteristics,general features,smoking cessation status,clinical characteristics,as well as social and psychological features including depression,anxiety,stress,social support,and coping strategies were collected.A binary unconditional Logistic regression model was used to analyze the factors associated with successful smoking cessation.Results Among the 490 valid samples,31.6%(155 individuals)successfully quit smoking during cART duration.The results of the multivariate analysis showed that having a college degree or above(aOR=1.97,95%CI:1.24-3.15),CD4 cell count>350 cells/μL(aOR=2.20,95%CI:1.36-3.58),cART duration≤3 years(aOR=2.09,95%CI:1.30-3.34),absence of other chronic diseases(aOR=2.23,95%CI:1.27-3.92),absence of depressive symptoms(aOR=2.26,95%CI:1.34-3.80),normal stress levels(aOR=2.50,95%CI:1.46-4.29),positive coping strategies(aOR=2.56,95%CI:1.42-4.63),higher social support(moderate social support aOR=2.90,95%CI:1.54-5.48;high social support aOR=3.69,95%CI:1.83-7.41),and the absence of suicidal ideation(aOR=1.72,95%CI:1.05-2.83)were associated with a higher success rate of smoking cessation among male HIV/AIDS patients.Conclusions The smoking cessation success rate is low among male HIV/AIDS patients receiving cART.In smoking cessation interventions,special attention should be paid to the health status of smokers,especially those with lower education levels.Providing timely professional psychological counseling and smoking cessation guidance can enhance their health awareness.Regular monitoring of their disease progression,increasing their level of social support,and constructing a comprehensive smoking cessation intervention model that integrates biological,psychological,and social factors are essential.The diagnosis of HIV infection is a crucial opportunity to initiate smoking cessation interventions,and smoking cessation strategies should be integrated into the care services for HIV-infected individuals.