Grant: Fellowship - PA: Health Services/Population Health HIV/AIDS Research

Rates of smoking in patients living with HIV/AIDS (PHAs) are greater than that of the general Canadian population and they continue to increase. As well, cardiovascular disease (CVD) rates are alarmingly increasing in PHAs. Given the large percentage of PHAs who smoke, this is a critical health care issue and research suggests that smoking is the strongest predictor for new cases of CVD in PHAs. Few effective smoking cessation programs have been developed for PHAs and one of the largest problems faced by smokers is staying quit. Current smoking status is also an important and strong predictor of adherence to highly active antiretroviral therapy (HAART), a crucial facet of care of PHA. Current smokers' adherence rates to HAART are lower than their non- or ex-smoker counterparts. Taken together, this suggests that smoking cessation and its relationship to adherence to HAART are important health behaviours in PHAs. This study will evaluate the success of a tailored quit smoking intervention for PHA. By comparing the quit smoking intervention and pharmaceutical assistance to quit smoking to pharmaceutical interventions only we will evaluate the importance and success of our psychological intervention. Success will be defined as adherence to health behaviours (a) the quit smoking pharmacotherapy, (b) abstinence from smoking and (c) adherence to HAART regimens. My hypotheses are as follows: 1) PHA receiving pharmacotherapy as well as a smoking cessation counseling program (targeting depression) will have higher rates of smoking abstinence than those receiving smoking cessation pharmacotherapy alone, (2) Adherence to HAART will be highest in those that remain quit vs. current or reduced smokers. This study will inform researchers and clinicians of the importance of smoking cessation in PHA and will provide a better understanding of the challenges (ie., depression) and benefits (increased HAART adherence, decreased risk of CVD) associated with smoking cessation in PHA.