ABSTRACT
High rates of cigarette smoking have been observed among HIV-positive individuals. Smoking has been linked to HIV-related medical complications and non-AIDS defining cancers and negatively impacts on immune function and virologic control. Although internalized heterosexism has been related to smoking behaviors, little is known about associations between partners' reports of smoking, internalized heterosexism, and HIV medication management in male couples with HIV. A sample of 266 male couples completed baseline assessments for a cohort study examining relationship factors and HIV treatment. A computer-based survey assessed self-reported smoking behaviors, alcohol use, internalized heterosexism, and antiretroviral therapy (ART) adherence. HIV-positive men also provided blood samples to assess viral load. Approximately 30% of the sample reported that they are currently smoking cigarettes. After adjusting for demographic characteristics, men in a primary relationship with a partner who reported currently smoking had more than five-fold greater odds of reporting smoking. Higher levels of internalized heterosexism and financial hardship were each independently associated with greater odds of reporting smoking. Among HIV-positive men on ART (n = 371), having a partner who reported smoking was associated with almost three-fold greater odds of having a detectable viral load. Our findings add new support to the evidence of romantic partners influencing each other's health behaviors, and demonstrate an association between smoking and disease management within male couples. Future research should explore the interpersonal and social contexts of smoking in order to develop interventions that meet the unique needs of male couples.
Subject(s)
Alcohol Drinking/psychology , Anti-HIV Agents/therapeutic use , HIV Infections/drug therapy , Homosexuality, Male/psychology , Self Concept , Smoking/adverse effects , Adult , Family Characteristics , HIV Infections/blood , HIV Infections/psychology , Humans , Interviews as Topic , Longitudinal Studies , Male , Medication Adherence/psychology , Medication Adherence/statistics & numerical data , San Francisco , Self Efficacy , Sexual Partners , Smoking/psychology , Socioeconomic Factors , Surveys and Questionnaires , Treatment Outcome , Viral Load , Young AdultABSTRACT
Beliefs about HIV treatment efficacy, adherence self-efficacy, and side effects management are related cross-sectionally to adherence to antiretroviral therapy (ART). However, the role of such expectancies held prior to the initiation of ART is unknown. The purpose of this study was to explore feasibility, satisfaction, and preliminary effects of an intervention to address HIV treatment expectancies. ART naïve participants (N = 26) who were contemplating ART initiation were randomized to a single session group intervention or standard care control condition. The session included an exploration of expectancies; an education about ART efficacy, adherence, and side effects; and guided problem solving around adherence and side effects management. The pilot intervention was feasible and was rated highly satisfactory. Follow-up assessments demonstrated that intervention participants increased adherence self-efficacy and positive side effects expectancies relative to those in the control group (ps<.05). Findings have implications for nursing practice and further research in the area of HIV treatment expectancies and treatment readiness.
