Reducing Ethnic Health Disparities: Motivating HIV+ Latinos to Quit Smoking

Advances in the treatment of HIV-disease have shown dramatic effects on improving immune
function in a significant proportion of people infected with HIV in the United States. For
the first time since the beginning of the HIV epidemic, individuals with HIV are faced with
the prospect of living longer, healthier lives. Cigarette smoking is highly prevalent among
HIV+ individuals and, in addition to the negative health consequences commonly resulting
from smoking, poses unique health risks to those with HIV. Our present research
investigation, Positive PATHS (PATHS), the only NIH-funded smoking cessation study in HIV+
persons, is designed to evaluate a clinic-based motivational smoking cessation intervention
among HIV+ smokers in Southern New England. Preliminary analysis of the PATHS investigation
indicate that both a standard care intervention (brief advice and NRT) and a more extensive
motivational counseling condition have similar biochemically verified smoking abstinence
rates 6-months post intervention, with Latino participants responding better to the brief
standard care condition. The goal of the current application is to expand upon the
preliminary results of this study and target the standard care intervention to Latino HIV+
patients who were found to respond best to a brief directive approach. This expanded
standard care approach will incorporate the use of culturally specific materials to provide
brief advice to both the patient and a patient-identified social support person who will be
trained in ways to support cessation efforts. Latinos are a population greatly affected by
HIV and tobacco use, yet rarely discussed in existing research. Most tobacco research that
includes Latinos has focused on prevention efforts. The few culturally specific cessation
interventions that have been done have focused mostly on Mexicans in the Southwest and
California1,2,3. Considering the diversity of the Latino population in the US, those
interventions may not generalize to Latinos in the Northeast, who are mostly of Puerto Rican
and Dominican origin. Research is limited in the area of HIV among Latinos and there are no
studies to date that address the problem of tobacco use among HIV+ Latinos. We propose to
address this disparity by focusing this particular research study on Latino men and women
living with HIV/AIDS.

Inclusion Criteria:

- Be receiving care for HIV at one of the participating immunology clinics

- Self-identify as being Latino/Hispanic (defined as being 1st, 2nd or 3rd generation
from any of the Spanish-speaking countries of North America, Central America, South
America and the Caribbean).

- Be 18 years old or older.

- Be current smokers of cigarettes (past 7 days)

- Speak English or Spanish

Exclusion Criteria:

- Are pregnant or nursing

- Have uncontrolled hypertension

- Use other forms of tobacco like cigars or chewing tobacco or are using anything else
to help them quit smoking

- Are allergic to the nicotine patch or have a skin condition like eczema or psoriasis
that makes them unable to use the patch