Relationship between smoking and medication adherence among individuals living with HIV in rural Appalachia

Background: Smoking is prevalent among individuals living with HIV and has been associated with HIV medication non-compliance; however, little research has been conducted to assess this relationship among rural residents. Therefore, the purpose of this study was to evaluate the prevalence of smoking behavior and its relationship to HIV medication adherence among individuals accessing HIV-related care in rural Appalachian. Methods: Data were collected from 82 individuals living with HIV/AIDS in rural Appalachia in 2010. Results: The majority of the sample was male, white, non-Hispanic, and had not received an AIDS diagnosis. The mean age of the participants was 47 years (SD = 10). Eighty-five percent of the sample had been prescribed HIV medication (n = 70); however, only 63% of these individuals (n = 44) were compliant (>95% dose adherence). Half of the sample (n = 41) reported smoking “every day” or “some days.” Those individuals who reported smoking were more likely to be non-compliant with their HIV medication than those individuals who did not report any smoking behavior, X2(1, N = 56) = 4.70; p = .04, Cramer's V = .27. There were no significant relationships between smoking and CD4 count, viral load, or education level, which contradicts previous research. Conclusion: Medication adherence was lower among smokers in this sample, which can reduce long-term HIV survival. Furthermore, smoking can increase the risk for other chronic diseases which can further complicate HIV disease. Therefore, it is essential that smoking cessation interventions be developed specifically for individuals living with HIV.