Tobacco Use among ARV Treated HIV Infected Rural South Africans: Prevalence and its Determinants

Abstract

Tobacco use remains one of the major cardiovascular risk factors and its use in antiretroviral (ARV) treated human immunodeficiency virus (HIV) infected people may lead to activation of immune cells and rendering them more susceptible to HIV. We determined the prevalence of and factors associated with tobacco use in an antiretroviral treated HIV infected rural African people. The study was a cross-sectional, conducted in three ARV clinics in rural Dikgale Health and Demographic Surveillance System (HDSS), South Africa. Socio-demographic, tobacco and alcohol use data were collected using World Health Organisation stepwise approach to surveillance (STEPS) questionnaire. The Chi-square test was used to compare categorical variables between tobacco users and non tobacco users. The multiple logistic regression analysis was used to determine the predictors of tobacco use status. Of 214 ARV treated HIV infected participants, 171 (79.9%) were females and 43 (20.1%) were males. The mean age of participants was 44.8 ± 11.8 years. About 45 (21%) of participants were tobacco users. A higher proportion of males than females (39.5% versus 16.4%, p=0.02) used tobacco. Older age >50years (p=0.01), marital status (p=0.03) and alcohol consumption (p=0.001) were significant independent predictors of tobacco use. Tobacco use among ARV treated HIV infected rural people was common. Older age, alcohol consumption and marital status were the risk factors for tobacco use. There is need to scale up the awareness on how tobacco use, apart from being a risk factor for CVD, interferes with viral suppression despite treatment with antiretroviral drugs.

Keywords: Tobacco Use, Cardiovascular Disease, Antiretroviral, Human Immunodeficiency Virus