title: A longitudinal study of persistent smoking among HIV-positive gay and bisexual men in primary relationships.
abstract: We examined the stability of smoking behaviors, and factors associated with persistent smoking in a longitudinal study of HIV-positive gay and bisexual men in primary relationships.
  
  
  
  A sample of 377 HIV-positive men on antiretroviral therapy and their same-sex partners completed five assessments over two years. Participants completed semi-structured interviews which assessed smoking status, sociodemographic factors, relationship dynamics, and HIV-related disease characteristics. Latent transition analysis estimated the amount of transition in smoking over time. Latent class analysis examined factors associated with smoking status across the study period.
  
  
  
  At baseline, 28.1% (n=106) of participants reported current smoking. Over 90% of the HIV-positive men remained in the same smoking category over time (68.4% persistent non-smokers; 24.1% persistent smokers). Men whose partners smoked and men with lower income had higher odds of being persistent smokers, whereas older men and men who identified as Latino race/ethnicity had lower odds of being persistent smokers compared to non-smokers.
  
  
  
  Despite efforts to reduce smoking among people living with HIV (PLWH), a substantial subset of men continued to smoke during their two years in the study. Findings suggest that primary partners who also smoke and low income were the strongest predictors of sustained smoking behaviors among HIV-positive men. Additional research is needed to better understand how to increase motivation and support for smoking cessation among PLWH and their primary partners, while attending to how socioeconomic status may inhibit access to and the sustained impact of existing smoking cessation programs.
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University School of Public Health, USA; Department of Behavioral and Social Sciences, Brown University School of Public Health, USA. Electronic address: Kristi_Gamarel@brown.edu.
authors.forename: Kristi E
authors.initials: KE
authors.lastname: Gamarel
authors.affiliation: Department of Medicine, University of California, San Francisco, USA.
authors.forename: Torsten B
authors.initials: TB
authors.lastname: Neilands
authors.affiliation: Department of Medicine, University of California, San Francisco, USA.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Conroy
authors.affiliation: Department of Medicine, University of California, San Francisco, USA.
authors.forename: Samantha E
authors.initials: SE
authors.lastname: Dilworth
authors.affiliation: Department of Medicine, University of California, San Francisco, USA.
authors.forename: Nadra
authors.initials: N
authors.lastname: Lisha
authors.affiliation: Department of Medicine, University of California, San Francisco, USA.
authors.forename: Jonelle M
authors.initials: JM
authors.lastname: Taylor
authors.affiliation: Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, USA.
authors.forename: Lynae A
authors.initials: LA
authors.lastname: Darbes
authors.affiliation: Department of Medicine, University of California, San Francisco, USA.
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001727:Bisexuality / Q000523:psychology* / Q000706:statistics & numerical data; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012495:San Francisco / Q000453:epidemiology; D012747:Sexual Partners / Q000523:psychology*; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Couples; HIV; Longitudinal; Smoking