Over a quarter of HIV-positive men were smokers, whereas only 16% of HIV-negative men were smokers, according to a study of 25 sub-Saharan countries including South Africa.
Mark Parascandola, of the National Cancer Institute of the US, presented the results of the study at the World Conference on Tobacco or Health.
“The reason is likely to vary from country to country, but it could be that smoking is associated with lower-income populations and this could be the same with HIV,” said Parascandola.
“Smokers may also tend to be more likely to engage in risky behaviour, so might be more likely to have unprotected sex.
“Smokers also generally have poorer healthy behaviour. They tend to have poorer diets and do less exercise.”
HIV-positive women were also more likely to smoke, although the smoking rate among women was very low (1.15% were smokers versus 0.73% non-smokers).
Parascandola said HIV-positive people in high-income countries including the US were also more likely to smoke.
“Both smoking and HIV are risk factors for tuberculosis, which is highly prevalent in some low- and middle-income countries,” said Parascandola.
“The results suggest that it would be important to integrate tobacco control into HIV treatment.”
Meanwhile, a random sample of 750 HIV-positive people at 17 healthcare facilities in the Western Cape found that one-fifth were smokers.
There were slightly more women smokers than men, while smokers were more likely to be unemployed and also drink more alcohol, according to a presentation by Muyunda Buwa from the SA Medical Research Council.
In addition, HIV-positive patients had high rates of hypertension, according to Buwa’s study.
“It is both timely and highly appropriate that research on the growing impact of smoking and infectious diseases such as HIV and TB is being released in South Africa, which has one of the highest infection rates of both diseases in the world,” said Professor Lekan Ayo-Yusuf, scientific chair of the conference.
“In South Africa, about 80% of TB patients are infected with HIV.