***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: INTRODUCTION Tobacco use is epidemic among persons living with HIV ( PLWH ) , and several studies have shown self-efficacy ( SE ) to be a predictor of successful cessation . This study examined sociobehavioral correlates of SE and its predictive value for successful cessation in a group of PLWH smokers . METHODS The study was conducted on combined patient data from 2 separate r and omized controlled trials of tobacco treatment for PLWH smokers . Both trials utilized the same SE scale at the same timepoints , and both had the same smoking cessation endpoint ( biochemically confirmed , 7-day , point prevalence abstinence at 3 months ) . Univariate and multivariate techniques were used to analyze the merged data set . RESULTS Baseline SE data were available for 272 subjects . The Self-Efficacy/Temptations Scale-Long Form demonstrated good internal reliability with overall and subscale Cronbach 's alpha of .77-.92 . Younger age , HIV risk other than injection drug use , recent alcohol use , and higher scores for anxiety , depression , loneliness , and nicotine dependence were all significantly correlated with lower baseline SE . Posttreatment SE was significantly predictive of successful cessation , whereas baseline SE was not . Subjects r and omized to the treatment interventions were significantly more likely to quit ( AOR = 2.99 [ 1.26 - 7.01 ] , p = .01 ) , and logistic regression suggested a possible mediating effect of posttreatment SE . CONCLUSIONS SE is tightly correlated with a number of modifiable affective and behavioral factors in PLWH smokers , and measures aim ed at increasing the SE to abstain in such individuals may enhance the effect of targeted tobacco treatment strategies OBJECTIVE To measure biopsychosocial domains related to tobacco use in persons living with HIV/AIDS ( PLWHAs ) . METHODS Cross-sectional interview study of 60 PLWHA smokers r and omly selected from an HIV clinic . RESULTS Participants averaged 14.4 cigarettes daily . Sixty-five percent were moderately or highly nicotine dependent , and most were motivated to quit . Substance use and depression were very common . Most reported that smoking helped them cope with depression , anxiety , and anger . Twenty-seven percent thought ( mistakenly ) that smoking raised their T-cell counts and /or helped fight infections . Referrals to quitlines or cessation programs were uncommon . CONCLUSIONS Smoking among PLWHAs is a challenging problem requiring targeted intervention strategies Persons living with HIV/AIDS who are current smokers are more likely to develop disease-related adverse health outcomes compared to nonsmokers with HIV/AIDS . However , the impact of smoking cessation on health outcomes such as symptom status and health-related quality of life ( HRQOL ) has not yet been assessed within this population . This study examined the effects of changes in smoking status on HIV-related symptom burden and health-related quality of life outcomes in a multiethnic , low-income population of persons living with HIV/AIDS . Patients ( n = 95 ) from a large , inner city HIV/AIDS clinic were enrolled in a smoking cessation trial providing nicotine replacement therapy , counseling , and self-help written material s. Biochemically verified smoking status , length of smoking abstinence , HIV-related symptom burden , and HRQOL were assessed approximately 3-months posttrial enrollment . A series of multiple linear regression models was performed to assess the associations between the smoking status variables and the health outcomes at follow-up while controlling for baseline levels . Length of smoking abstinence was significantly associated ( p = 0.02 ) with HIV-related symptom burden . Specifically , increasing number of consecutive days of smoking abstinence during the 3-month follow-up period was associated with lower levels of HIV-related symptom burden at the time of follow-up . However , 24-hour smoking prevalence was not significantly ( p > 0.05 ) associated with changes in either HIV-related symptom burden or HRQOL . These findings suggest that smoking cessation can significantly improve symptom burden for individuals living with HIV/AIDS . Moreover , these benefits are observable as early as 3 months after quitting and are positively correlated with the length of abstinence Objective : To evaluate the feasibility and preliminary efficacy of a Web-based tobacco treatment for persons living with HIV ( PLWH ) . Design : Prospect i ve , r and omized controlled trial . Setting : HIV-care center in the Bronx , New York . Subjects : Eligibility criteria included HIV infection , current tobacco usage , interest in quitting , and access to a computer with internet . One hundred thirty-eight subjects enrolled , and 134 completed the study . Intervention : Positively Smoke Free on the Web ( PSFW ) , an 8-session , 7-week targeted tobacco treatment program for PLWH  , was compared with st and ard care ( brief advice to quit and self-help brochure ) . All subjects were offered nicotine patches . Main Outcome Measures : The main feasibility outcomes were number of sessions logged into , number of Web pages visited , number of interactive clicks , and total time logged in . The main efficacy outcome was biochemically verified , 7-day point prevalence abstinence 3 months after intervention . Results : PSFW subjects logged into a mean of 5.5 of 8 sessions and 26.2 of 41 pages . They executed a mean of 10 interactive clicks during a mean total of 59.8 minutes logged in . Most required reminder phone calls to complete the sessions . Educational level , anxiety score , and home access of the Web site were associated with Web site usage . Ten percent of the PSFW group vs. 4.3 % of controls achieved the abstinence end point . Among those who completed all 8 sessions , 17.9 % were abstinent , and among women completers , 30.8 % were abstinent . Conclusions : Web-based treatment is a feasible strategy for PLWH smokers , and preliminary findings suggest therapeutic efficacy Background : More than half of the persons living with human immunodeficiency virus ( HIV ; PLWH ) in the US smoke cigarettes , and tobacco use is responsible for considerable morbidity and mortality in this group . Little is known about the efficacy of tobacco treatment strategies in PLWH . Design : R and omized controlled trial comparing Positively Smoke Free ( PSF ) , an intensive group-therapy intervention targeting HIV-infected smokers , to st and ard care . Methods : A cohort of 145 PLWH smokers , recruited from an HIV-care center in the Bronx , New York , were r and omized 1:1 into the PSF program or st and ard care . All were offered a 3-month supply of nicotine replacement therapy . PSF is an 8-session program tailored to address the needs and concerns of HIV-infected smokers . The sessions were cofacilitated by a graduate student and an HIV-infected peer . The primary outcome was biochemically confirmed , 7-day point-prevalence abstinence at 3 months . Results : In the intention-to-treat analysis , PSF condition subjects had nearly double the quit rate of controls ( 19.2 % vs. 9.7 % , P = 0.11 ) . In the complete case , as-treated analysis , assignment to PSF was associated with increased odds of quitting ( odds ratioadj 3.55 , 95 % confidence interval 1.04 to 12.0 ) . Latino ethnicity and lower loneliness score were predictive of abstinence . The subjects in the PSF condition exhibited significant decreases in daily cigarette consumption and significant increases in self-efficacy and in motivation to quit . Attendance of ≥7 sessions was associated with higher quit rates . Conclusions : These findings suggest a positive effect of PSF on cessation rates in PLWH smokers .  Loneliness and self-efficacy are influential factors in the smoking behaviors of PLWH Smoking is highly prevalent among HIV+ individuals and studies indicate that it may be associated with poor ART adherence , though the relationship is poorly understood . In addition little is known about interest in quitting among HIV+ smokers who are having adherence difficulties . We examined smoking and ART adherence  among 203 HIV+ individuals enrolled in a r and omized trial of interventions to increase ART adherence . Prior analyses indicated there were no overall treatment group effects . Smoking status and motivation to quit was assessed at baseline and ART adherence was assessed at week 12 , 24 , 36 , and 48 . Longitudinal generalized estimating equation analysis that controlled for treatment group revealed that smoking status was not significantly related to adherence over time . Motivation to quit was high with 58 % intending to quit in the next 6 months and 25 % intending to quit in the next 30 days . Findings suggest that smoking is not associated with adherence among those with adherence difficulties . However it does not diminish importance of addressing both behaviors especially given HIV+ smokers substantial interest in changing smoking behavior . ResumenFumar es altamente prevalente entre las personas VIH-positivas y investigaciones indican que puede ser asociado con la baja adherencia a los medicamentos antiretrovirales aunque la relación no es muy entendible . Además se sabe poco sobre el interés en dejar de fumar entre los fumadores VIH-positivos que están teniendo dificultades de adherencia . Examinamos la relación entre el fumar y adherencia a los medicamentos antiretrovirales entre 203 personas VIH-positivas reclutadas a una investigación aleatoria de intervenciones para aumentar la adherencia antirretroviral . Los análisis previos indicaban que no había efectos globales del grupo de tratamiento . El consumo de tabaco y la motivación para dejar de fumar se evaluó al inicio de la investigación y la adherencia antirretroviral se evaluó en la semana 12 , 24 , 36 , y 48 . Análisis de la ecuación de estimación generalizada longitudinal control and o por el efecto del grupo de tratamiento mostro que el consumo de tabaco no se relacionó significativamente con la adherencia con el tiempo . La motivación para dejar de fumar fue alta con el 58 % de personas con intención de dejar de fumar en los próximos 6 meses y el 25 % con la intención de dejar de fumar en los próximos 30 días . Los result ados sugieren que el fumar no está asociado con la adherencia de medicamentos antiretrovirales entre las personas con dificultades de adherencia . Sin embargo , no disminuye la importancia de abordar ambas conductas especialmente dado el interés sustancial de cambiar el consumo de tabaco entre fumadores VIH-positivos Unhealthy substance-use behaviors , including a heavy alcohol intake , illicit drug use , and cigarette smoking , are engaged in by many HIV-positive individuals , often as a way to manage their disease-related symptoms . This study , based on data from a larger r and omized controlled trial of an HIV/AIDS symptom management manual , examines the prevalence and characteristics of unhealthy behaviors in relation to HIV/AIDS symptoms . The mean age of the sample ( n = 775 ) was 42.8 years and 38.5 % of the sample was female . The mean number of years living with HIV was 9.1 years . The specific self-reported unhealthy substance-use behaviors were the use of marijuana , cigarettes , a large amount of alcohol , and illicit drugs . A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance-use behaviors , including amphetamine and injection drug use , heavy alcohol use , cigarette smoking , and marijuana use . The implication s for clinical practice include the assessment of self-care behaviors , screening for substance abuse , and education of persons regarding the self-management of HIV Background : Asymptomatic ischaemic heart disease ( IHD ) in HIV-infected patients has not been studied . Methods : Resting , 12-lead electrocardiograms ( ECG ) were evaluated for asymptomatic IHD ( Q-wave and /or ST segment depression ) at baseline from HIV-infected participants with no known IHD enrolling in the SMART study . The ECG recordings were st and ardized and central ly analysed . Factors associated with asymptomatic IHD were identified by logistic regression , sequentially adjusted for demographics , clinical history , metabolic risk factors and type and duration of antiretroviral therapy ( ART ) . Results : Of 4831 participants with an evaluable , baseline ECG and no prior IHD , mean age was 44 years ( SD , 9.3 ) ; 28.4 % were female ; 6.6 % had diabetes ; 16.5 % were receiving antihypertensive therapy ; and 95.4 % were ART experienced .  ECG evidence of IHD was detected in 526 ( 10.9 % ) [ Q-wave in 283 ( 5.9 % ) , ST segment depression in 264 ( 5.5 % ) ] ; 16.7 % in those 60 years or older . Variables independently associated with these abnormalities were older age [ age ≥ 60 versus < 40 years : odds ratio ( OR ) , 2.2 ; 95 % confidence interval ( CI ) , 1.5–3.2 ; P < 0.001 ] , current antihypertensive therapy ( OR , 1.5 ; 95 % CI , 1.1–1.9 ; P = 0.003 ) and recruitment in Europe ( OR , 1.4 ; 95 % CI , 1.1–1.7 ; P = 0.0 
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Discussion : Unlike the general US population , there was no difference in smoking prevalence for female versus male PLWH ( both > 50 % ) indicating that HIV infection status was associated with a greater relative increase in smoking for women than men .