Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition

Uthman, Olalekan A., Ekström, Anna Mia and Moradi, Tahereh T (2016) 'Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition'. BMC Public Health, Vol 16, Issue 998.

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Abstract

Background
Smoking is still gaining ground in Sub-Saharan Africa, especially among socially disadvantaged groups. People living with HIV represent a subgroup with a significantly elevated prevalence of cigarette smoking. The objective of the study was to examine the influence of individual-, neighbourhood- and country-level socioeconomic position on current cigarette smoking among people living with HIV in Sub-Saharan Africa.

Methods
We applied multivariable multilevel logistic regression analysis on Demographic and Health Survey data collected between 2003 and 2012 in sub-Saharan Africa. We identified 31,270 individual living with HIV (Level 1) nested within 7,054 neighbourhoods (Level 2) from 19 countries (Level 3).

Results
After adjustment for individual-, neighbourhood- and country-level factors, respondents, the following significant independent risk factors for increasing odds of being a current cigarette smokers among people living with HIV: male gender (odds ratio [OR] = 62.49; 95 % credible interval [CrI] 45.93 to 78.28), from the poorer households (OR = 1.62, 95 % CrI 1.38 to 1.90); living in urban areas (OR = 1.24, 95 % CrI 1.09 to 1.41), from neighbourhoods with low poverty rate (OR = 1.25, 95 % CrI 1.09 to 1.43), illiteracy rate (OR = 1.28, 95 % CrI 1.14 to 1.42), low unemployment rate (OR = 1.11, 95 % crI 1.01 to 1.43); and from countries with low socio-economic deprivation (OR = 1.53, 95 CrI 1.08 to 1.96). About 3.4 % and 39.4 % variation in cigarette smoking behaviour among people living with HIV is conditioned by differences between neighbourhoods and countries.

Conclusions
Gender, education and socioeconomic context are independently associated with current cigarette smoking among people living with HIV in sub-Saharan Africa.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WA Public Health > Air pollution > WA 754 Pollution and pollutants (incl. tobacco pollution; passive smoking) WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.5 Complications WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.7 Psychosocial aspects
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/s12889-016-3637-1
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	24 Oct 2016 09:41
Last Modified:	06 Feb 2018 13:13
URI:	https://archive.lstmed.ac.uk/id/eprint/6300

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