Tobacco use and the relationship with HIV risk behaviors in Puerto Rico residents of 18 years and over – A cross-sectional study

Abstract

Background: Currently there is no country, social class, or group of people worldwide that has not been affected by HIV/AIDS. The HIV epidemic has been surrounded by great secrecy and ignorance that has fostered the spread of the virus. HIV/AIDS and tobacco use represent the only two major causes of death worldwide. Likewise, tobacco use is a leading cause of morbidity and mortality in people without HIV and is highly prevalent in HIV positive population. The main objective of this research is to provide an epidemiological profile of people who reported having an HIV test in their lifetime and smoke (PHHT-S) in Puerto Rico. Our secondary objectives are: 1) identify the existence of statistically significant differences between PHHT-S vs. people who have had an HIV test in their lifetime and do not smoke (PHHT-NS), and 2) determine the risk of having been in a risk situation for HIV infection among PHHT-S vs. PHHT-NS.

Methods: Through a cross-sectional study methodology the analysis of 2010 database of the Puerto Rico Behavioral Risk Factor Surveillance System (PRBRFSS) was performed with the Statistical Package for the Social Sciences (SPSS). In the first part, a univariate analysis was performed using frequency distributions and percentages for categorical variables and means and standard deviation calculation for continuous variables. In the second part through a bivariate analysis, smokers and non-smokers who have had an HIV test in their lifetime were compared using chi-square tests, Odds Ratio and 95% confidence intervals (CI).

Results: Among the 43.2% (1,009,587) of the Puerto Ricans of 18 years and over who reported having an HIV test in their lifetime, 16.6% (167,242) reported being smokers. This study provides statistically significant data to support the existence of differences between PHHT-S and PHHT-NS, especially in the area of risk behaviors related to HIV. PHHT-S are 2.24 times more likely to engage in some risky behavior that can lead them become infected with HIV in comparison with the PHHT-NS.

Conclusions: This study provides strong evidence that confirm the need for collaboration between the Tobacco Control Programs and HIV programs to implement new strategies to promote a greater number of people who smoke get tested for HIV and to influence public policy and systems change.