{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T22:30:02Z","timestamp":1773700202494,"version":"3.50.1"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Smoking is highly prevalent among HIV-infected individuals and is associated with high morbidity and mortality. Studies on smoking among HIV-infected individuals in China, especially compared to uninfected individuals, are scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to investigate and compare the prevalence and factors associated with smoking between HIV-infected and uninfected men in Guilin, China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A survey was conducted among 1,395 HIV-infected men at Guilin Third People\u2019s Hospital from June to December 2022, with a 1:2 age (\u00b11\u202fyear) and education-matched control group of 2,790 HIV-uninfected men, whose data were collected from March to August 2023. Both groups completed an online questionnaire on smoking behaviors and relevant characteristics, with a comparative analysis of associated factors conducted using chi-square tests and multivariable logistic regressions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rates of former smokers were comparable between HIV-infected and uninfected men [12.3% (95% CI: 10.7\u201313.9%) vs. 12.0% (95% CI: 10.9\u201313.1%)], but the current smoking rate was significantly higher in the infected group than in the uninfected group [37.6% (95% CI: 35.2\u201340.0%) vs. 27.6% (95% CI: 25.9\u201329.3%), <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05]. In both groups, the following factors were significantly associated with smoking: higher income, presence of chronic diseases, negative coping styles, lower social support, and having depression, anxiety, and suicidal ideation. Additionally, in HIV-infected men, the following factors were exclusively associated with smoking: heterosexual HIV transmission route, lower CD4+ T cell count, longer duration of antiretroviral therapy (ART), and drug use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HIV-infected men had higher smoking rates than their uninfected counterparts, indicating that HIV diagnosis may be a critical timing to initiate behavioral changes and deliver smoking cessation interventions. Furthermore, multiple demographic, clinical, and psychosocial factors were associated with smoking, indicating the need to develop and implement comprehensive smoking cessation prevention and intervention programs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2024.1422144","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T15:27:31Z","timestamp":1735054051000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of smoking behaviors and associated factors between HIV-infected and uninfected men in Guilin, China: a case\u2013control study"],"prefix":"10.3389","volume":"15","author":[{"given":"Yong","family":"Yu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuqun","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengqiu","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liman","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenyu","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s40249-021-00799-3","article-title":"Global burden of active smoking among people living with HIV on antiretroviral therapy: a systematic review and meta-analysis","volume":"10","author":"Ale","year":"2021","journal-title":"Infect. Dis. Poverty"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"340","DOI":"10.3138\/cjhs.2022-0048","article-title":"A systematic review of psychosocial challenges for MSM living with HIV among diverse and intersecting minorities","volume":"32","author":"Amato","year":"2023","journal-title":"Can. J. Hum. Sex."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s10389-019-01062-8","article-title":"Impact of tobacco smoke in HIV progression: a major risk factor for the development of NeuroAIDS and associated of CNS disorders","volume":"28","author":"Bhalerao","year":"2020","journal-title":"Z Gesundh Wiss."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"21745","DOI":"10.1038\/s41598-023-39861-5","article-title":"Combined effects of smoking and HIV infection on the occurrence of aging-related manifestations","volume":"13","author":"Boyer","year":"2023","journal-title":"Sci. Rep."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1007\/s12529-016-9568-5","article-title":"The moderating effect of smoking status on the relation between anxiety sensitivity, sexual compulsivity, and suicidality among people with HIV\/AIDS","volume":"24","author":"Brandt","year":"2017","journal-title":"Int. J. Behav. Med."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1007\/s11481-020-09963-2","article-title":"Independent and combined effects of nicotine or chronic tobacco smoking and HIV on the brain: a review of preclinical and clinical studies","volume":"15","author":"Chang","year":"2020","journal-title":"J. Neuroimmune Pharmacol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1007\/s11481-017-9728-7","article-title":"Chronic tobacco-smoking on psychopathological symptoms, impulsivity and cognitive deficits in HIV-infected individuals","volume":"12","author":"Chang","year":"2017","journal-title":"J. Neuroimmune Pharmacol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"893","DOI":"10.13419\/j.cnki.aids.2024.09.01","article-title":"National HIV\/STD epidemic report, second quarter of 2024","volume":"30","year":"2024","journal-title":"Chin. J. AIDS STD."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1097\/QAI.0000000000001636","article-title":"Associations between multiple forms of discrimination and tobacco use among people living with HIV: the mediating role of avoidance coping","volume":"78","author":"Crockett","year":"2018","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"19729","DOI":"10.7448\/IAS.17.4.19729","article-title":"Smoking prevalence, readiness to quit and smoking cessation in HIV+ patients in Germany and Austria","volume":"17","author":"Degen","year":"2014","journal-title":"J. Int. AIDS Soc."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1111\/hiv.12358","article-title":"Smoking and projected cardiovascular risk in an HIV-positive Asian regional cohort","volume":"17","author":"do","year":"2016","journal-title":"HIV Med."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1093\/ntr\/ntx145","article-title":"Prevalence and correlates of smoking among people living with HIV in South Africa","volume":"20","author":"Elf","year":"2018","journal-title":"Nicotine Tob. Res."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1093\/ntr\/ntz097","article-title":"Engagement and 3-month outcomes from a digital E-cigarette cessation program in a cohort of 27 000 teens and young adults","volume":"22","author":"Graham","year":"2020","journal-title":"Nicotine Tob. Res."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1097\/QAD.0000000000002815","article-title":"Worldwide relative smoking prevalence among people living with and without HIV","volume":"35","author":"Johnston","year":"2021","journal-title":"AIDS"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1111\/add.12972","article-title":"Are predictors of making a quit attempt the same as predictors of 3-month abstinence from smoking? Findings from a sample of smokers recruited for a study of computer-tailored smoking cessation advice in primary care","volume":"110","author":"Kale","year":"2015","journal-title":"Addiction"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1093\/ntr\/ntx139","article-title":"Qualitative exploration of a smoking cessation trial for people living with HIV in South Africa","volume":"20","author":"Krishnan","year":"2018","journal-title":"Nicotine Tob. Res."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2177","DOI":"10.1093\/ntr\/ntw126","article-title":"Smoking cessation for people living with HIV\/AIDS: a literature review and synthesis","volume":"18","author":"Ledgerwood","year":"2016","journal-title":"Nicotine Tob. Res."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1037\/bul0000003","article-title":"Anxiety, depression, and cigarette smoking: a transdiagnostic vulnerability framework to understanding emotion-smoking comorbidity","volume":"141","author":"Leventhal","year":"2015","journal-title":"Psychol. Bull."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"862","DOI":"10.3969\/j.issn.1000-6729.2011.11.013","article-title":"Reliability and validity of the Chinese version of Beck scale for suicide ideation (BSI-CV) among university students","volume":"25","author":"Li","year":"2011","journal-title":"Chin. Ment. Health J."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1097\/QAD.0000000000003138","article-title":"Contributions of chronic tobacco smoking to HIV-associated brain atrophy and cognitive deficits","volume":"36","author":"Liang","year":"2022","journal-title":"AIDS"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"464","DOI":"10.3390\/ijerph17020464","article-title":"Anxiety and depression associated with anal sexual practices among HIV-negative men who have sex with men in Western China","volume":"17","author":"Liu","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"100697","DOI":"10.1016\/j.eclinm.2020.100697","article-title":"Acrolein and other toxicant exposures in relation to cardiovascular disease among marijuana and tobacco smokers in a longitudinal cohort of HIV-positive and negative adults","volume":"31","author":"Lorenz","year":"2021","journal-title":"EClinicalMedicine."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.drugalcdep.2013.09.023","article-title":"Tobacco use among HIV-infected individuals in a rural community in Yunnan province, China","volume":"134","author":"Luo","year":"2014","journal-title":"Drug Alcohol Depend."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.addbeh.2010.08.022","article-title":"Tobacco use and nicotine dependence among HIV-infected and uninfected injection drug users","volume":"36","author":"Marshall","year":"2011","journal-title":"Addict. Behav."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1080\/09540121.2021.1929813","article-title":"Tobacco smoking and HIV-related immunologic and virologic response among individuals of the Canadian HIV observational cohort (CANOC)","volume":"34","author":"McClean","year":"2022","journal-title":"AIDS Care"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.annepidem.2003.10.001","article-title":"Injection drug use and crack cocaine smoking: independent and dual risk behaviors for HIV infection","volume":"14","author":"McCoy","year":"2004","journal-title":"Ann. Epidemiol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"335","DOI":"10.7326\/M14-0954","article-title":"Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys","volume":"162","author":"Mdodo","year":"2015","journal-title":"Ann. Intern. Med."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1007\/s10508-011-9754-0","article-title":"The influence of physical body traits and masculinity on anal sex roles in gay and bisexual men","volume":"40","author":"Moskowitz","year":"2011","journal-title":"Arch. Sex. Behav."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e0229411","DOI":"10.1371\/journal.pone.0229411","article-title":"mHealth smoking cessation intervention among high school students: 3-month primary outcome findings from a randomized controlled trial","volume":"15","author":"M\u00fcssener","year":"2020","journal-title":"PLoS One"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1448","DOI":"10.16462\/j.cnki.zhjbkz.2019.004","article-title":"Comparison of prevalence and correlates of smoking between males with and without HIV-infection in Taizhou City","volume":"23","author":"Ning","year":"2019","journal-title":"Chin. J. Dis. Control Prev."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1696","DOI":"10.1080\/17441692.2020.1834598","article-title":"Experiences of minority stress among gay, bisexual, and other men who have sex with men (GBMSM) in Nigeria, Africa: the intersection of mental health, substance use, and HIV sexual risk behavior","volume":"16","author":"Ogunbajo","year":"2021","journal-title":"Glob. Public Health"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1007\/s10461-013-0663-1","article-title":"Current cigarette smoking among HIV-positive current and former drug users: associations with individual and social characteristics","volume":"18","author":"Pacek","year":"2014","journal-title":"AIDS Behav."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/1757975913499800","article-title":"Methodology of the global adult tobacco survey - 2008-2010","volume":"23","author":"Palipudi","year":"2016","journal-title":"Glob. Health Promot."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1080\/10615806.2013.860969","article-title":"A stress and coping perspective on health behaviors: theoretical and methodological considerations","volume":"27","author":"Park","year":"2014","journal-title":"Anxiety Stress Coping"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1001\/jamainternmed.2017.4349","article-title":"Lung Cancer mortality associated with smoking and smoking cessation among people living with HIV in the United States","volume":"177","author":"Reddy","year":"2017","journal-title":"JAMA Intern. Med."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e0153103","DOI":"10.1371\/journal.pone.0153103","article-title":"Determinants of smoking and quitting in HIV-infected individuals","volume":"11","author":"Regan","year":"2016","journal-title":"PLoS One"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1136\/bmjspcare-2019-001952","article-title":"Global prevalence of depression in HIV\/AIDS: a systematic review and meta-analysis","volume":"9","author":"Rezaei","year":"2019","journal-title":"BMJ Support. Palliat. Care"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1007\/s11904-019-00421-0","article-title":"HIV, depression, and cognitive impairment in the era of effective antiretroviral therapy","volume":"16","author":"Rubin","year":"2019","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1177\/10497323231166796","article-title":"The (De) normalisation of smoking among apprentices: plurality of settings, norms and vulnerability levels","volume":"34","author":"Saetta","year":"2023","journal-title":"Qual. Health Res."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1093\/pubmed\/fdm070","article-title":"Smoking cessation and financial stress","volume":"29","author":"Siahpush","year":"2007","journal-title":"J. Public Health (Oxf.)"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1515\/ijamh-2023-0001","article-title":"The prevalence of smoking cigarettes among HIV-infected patients after a decade. Single-center analysis","volume":"35","author":"Tochman","year":"2023","journal-title":"Int. J. Adolesc. Med. Health"},{"key":"ref42","volume-title":"Global HIV & AIDS statistics \u2014 Fact sheet","year":"2024"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1097\/QAI.0000000000002532","article-title":"Frequency, risk factors, and mediators of frailty transitions during long-term follow-up among people with HIV and HIV-negative AGEhIV cohort participants","volume":"86","author":"Verheij","year":"2021","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1080\/09540121.2015.1090536","article-title":"Cigarette smoking among Chinese PLWHA: an exploration of changes in smoking after being tested HIV positive","volume":"28","author":"Wang","year":"2016","journal-title":"AIDS Care"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e88","DOI":"10.1037\/pas0000207","article-title":"Cross-cultural validation of the depression anxiety stress Scale-21 in China","volume":"28","author":"Wang","year":"2016","journal-title":"Psychol. Assess."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"416","DOI":"10.3109\/00952990.2016.1171327","article-title":"Depression and cigarette smoking behavior: a critical review of population-based studies","volume":"43","author":"Weinberger","year":"2017","journal-title":"Am. J. Drug Alcohol Abuse"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/j.pmedr.2015.10.011","article-title":"Associations between smoking behaviors and financial stress among low-income smokers","volume":"2","author":"Widome","year":"2015","journal-title":"Prev. Med. Rep."},{"key":"ref48","first-page":"4","article-title":"The theoretical foundation and research applications of the Social Support Rating Scale","author":"Xiao","year":"1994","journal-title":"Chinese Journal of Clinical Psychiatry"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"114","DOI":"10.16128\/j\/cnki\/1005-3611.1998.02.018","article-title":"A preliminary study on the reliability and validity of the simple coping style scale","volume":"6","author":"Xie","year":"1998","journal-title":"Chin. J. Clin. Psychol."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"2411","DOI":"10.1007\/s10461-022-03968-z","article-title":"HIV disclosure among sexually infected people living with HIV and AIDS in China: prevalence, influencing factors, and negative outcomes","volume":"27","author":"Yu","year":"2023","journal-title":"AIDS Behav."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12911-017-0470-0","article-title":"How the public uses social media wechat to obtain health information in China: a survey study","volume":"17","author":"Zhang","year":"2017","journal-title":"BMC Med. Inform. Decis. Mak."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2024.1422144\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T15:27:37Z","timestamp":1735054057000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2024.1422144\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,24]]},"references-count":51,"alternative-id":["10.3389\/fpsyg.2024.1422144"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2024.1422144","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,24]]},"article-number":"1422144"}}