PREVALENCE AND RISK FACTORS OF E-CIGARETTES AND NRT USE AMONG HIV-INFECTED AND UNINFECTED MEN WHO HAVE SEX WITH MEN
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Background: The prevalence of e-cigarettes and NRT use is increasing among general population in recent years. With the shifting in HIV-infection paradigm, describing the prevalence and pattern among men with high risk of HIV infection is important in chronic disease prevention and improving their life expectancy and quality. Objective: The aims of this study were 1) to provide a profile of current smoking, e-cigarettes use and NRT use; 2) to identify risk factors associated with initiation of e-cigarettes and NRT use among men with high risk of HIV infection. Design: A longitudinal study based on The Multicenter AIDS Cohort Study (MACS). A total of 2285 men were included with follow-ups starting from June 2015. Results: The prevalence of current smokers was constant from 2015 to 2017. Men without HIV had a similar prevalence as the general US adult men (16.7%-17.5%), at between 13.5% and 16.1%. Men with HIV had a higher prevalence at between 23.0% and 26.1%. The prevalence of e-cigarettes (ranged between 5.2% to 9.3% for HIV infected men and between 3.1% and 5.7% for uninfected men) and NRT use (ranged between 5.0% and 8.2% for infected men and between 3.5% and 4.6% for uninfected men.) did not differ by HIV status. The prevalence of e-cigarettes use was about 20% in current smokers, 4% in former smokers, and 0.3% for non-smokers. The prevalence of NRT use was about 12% in current smokers and about 3% in former smokers. Ever e-cigarettes and NRT users had a higher cumulative pack-year compared to never users. After adjusting for age, race, Hispanic ethnicity, education level, serostatus, detectable viral load, CD4 count and cumulative pack-years, the cumulative incidence risk (RR) ratio of e-cigarettes use was 0.98 (95% CI, 0.97-0.99) for one year increase in age; 1.46 (95% CI, 1.01-2.10) for high school level education compared to 4 years’ college and above, 1.55 (95% CI, 1.03-2.35) for less than high school education compared to 4 years’ college and above, 1.09 (95% CI, 0.98-1.23) for HIV infection, and 1.02 (95% CI, 0.99-1.04) for 50% increase in cumulative pack-years. The cumulative incidence risk ratio of NRT use is 0.95(95% CI, 0.95-0.97) for one-year increase in age, 1.32 (95%CI, 1.00-1.73) for being back, 1.48 (95% CI, 1.02-2.15) for high school level education compared to 4 years’ college and above, 1.31(95% CI, 0.99-1.72) and 1.10 (95% CI, 1.07-1.14) for 50% increase in cumulative pack-years. Conclusion: The prevalence of current smoking was higher for men with HIV than men without. E-cigarettes and NRT use was mostly common among current smokers, the prevalence did not differ by HIV status. E-cigarettes and NRT users had a longer cumulative pack-years compared to never users. Risk factors associated with e-cigarettes and NRT use included younger age, lower education level, HIV infection and longer cumulative pack-years. Black race is associated with NRT use.