title: Human immunodeficiency virus, smoking and self-rated health in Harare, Zimbabwe.
abstract: METHODS
  Twenty-two urban factories in Harare.
  
  
  OBJECTIVE
  To determine the relationship between the human immunodeficiency virus (HIV), smoking and self-rated health in a high HIV prevalence urban workforce.
  
  
  METHODS
  Cross-sectional survey.
  
  
  RESULTS
  Of 7482 employees, 6111 (82%) consented to interview and anonymous HIV serology; 88% were male; median age was 34 years. HIV prevalence was 19%. Current (median 6 cigarettes per day) and former smoking were reported by 17% and 7%, respectively. Smoking (current or former) was more common among HIV-positive (27%) than -negative participants (17%; P < 0.001). Factors significantly associated with being a smoker on multivariate analysis were being HIV-infected (OR 1.5, 95% CI 1.4-1.7), older age (P < 0.001), non-Christian (OR 1.6, 95% CI 1.2-2.2) and manual job (OR 1.4, 95% CI 1.2-1.6). Women (OR 0.05, 95% CI 0.03-0.11) and the better educated (OR 0.7, 95% CI 0.5-0.9) were significantly less likely to smoke. HIV-positive smokers had the highest risk of reporting poor health (adjusted OR compared to HIV-negative non-smokers 3.4, 95% CI 2.3-5.0).
  
  
  CONCLUSIONS
  Smoking was significantly more common among HIV-positive than -negative employees in this predominantly male workforce. There was evidence of a combined effect on self-rated poor health, a variable shown to be a strong independent predictor of mortality in industrialised countries. Interventions to encourage smoking cessation may be an important component of HIV care in Southern Africa.
authors.affiliation: National Institute of Health Research (former Blair Research Institute), Harare, Zimbabwe. smunyati@mrczimshared.co.zw
authors.forename: S S
authors.initials: SS
authors.lastname: Munyati
authors.forename: N
authors.initials: N
authors.lastname: Redzo
authors.forename: E
authors.initials: E
authors.lastname: Dauya
authors.forename: R
authors.initials: R
authors.lastname: Matambo
authors.forename: B
authors.initials: B
authors.lastname: Makamure
authors.forename: T
authors.initials: T
authors.lastname: Bandason
authors.forename: A E
authors.initials: AE
authors.lastname: Butterworth
authors.forename: L
authors.initials: L
authors.lastname: Gwanzura
authors.forename: S
authors.initials: S
authors.lastname: Rusakaniko
authors.forename: P R
authors.initials: PR
authors.lastname: Mason
authors.forename: E L
authors.initials: EL
authors.lastname: Corbett
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000453:epidemiology*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D014505:Urban Population; D015030:Zimbabwe / Q000453:epidemiology