For HIV-positive people who smoke cigarettes, smoking may now be more harmful than the virus itself, a recent study found. With higher rates of smoking among HIV-positive individuals, health professionals and people living with the virus hope the blunt wake-up call draws more attention to smoking's potentially deadly impact on the community.
Researchers found that smoking among HIV-positive people taking effective medication regularly can reduce their life span by about twice as much as HIV itself. Even HIV-positive men who are non-adherent to medication or don't receive care have a lower life expectancy if they smoke, according to the study.
"Smoking is now the leading killer of people with HIV who are on anti-retrovirals," Dr. Krishna P. Reddy, the study's author and a Harvard Medical School instructor, explained. He said 20 years ago, most HIV-positive people didn't live long enough to experience the harmful effects of smoking. Today, HIV medicines are highly effective. According to Dr. Reddy, an HIV-positive person who has access to early treatment and can consistently monitor and manage the virus can live nearly as long as someone without HIV.
Smoking is a particularly prevalent habit among HIV-positive people. The National Institutes of Health reported in 2011 that 50 to 70 percent of people living with HIV in the U.S. are current smokers—in comparison, the CDC estimates nearly 17 percent of the adult population smokes.
"We see people that react to becoming HIV positive by increasing use of alcohol and tobacco," Antonio Ruberto Jr., Senior Director of Behavioral Health at New York's LGBT Community Center, told NBC OUT.
Dr. Celeste Watkins-Hayes, a Northwestern University Associate Professor of Sociology and African American Studies, said people who already have disadvantaged statuses because of their race, class or sexuality are disproportionately impacted by the virus. Ruberto noted that the discrimination and stigma many HIV-positive minority individuals face cause them added anxiety and increase their risk of turning to harmful habits like smoking.
"Smoking may in fact operate as a coping mechanism to deal with other stressors in their lives," Dr. Watkins-Hayes said. She said a large number of women living with HIV are impacted by other issues such as poverty, substance abuse or a history of homelessness.
HIV activist and blogger Jeffrey Newman said stress contributed to his cigarette smoking habit. As an HIV-positive person, Newman said he was more concerned with managing the virus than his cigarette use. Newman said he lost a lot of friends to HIV but not to smoking. He stopped smoking a few months ago and said this new study was a huge wake-up call.
"I've survived for 15 years with HIV, " Newman said. "Now I come to find out that this little thing that looks so harmless could kills me faster and quicker than HIV."
Dr. Reddy said it is never too late to quit. The study found that men and women with the virus who entered HIV care at age 40 and continued to smoke lost 6.7 and 6.3 years of projected life span, respectively, compared with HIV positive people who never used cigarettes. However, if they quit smoking at 40, they got back 5.7 and 4.6 years on their life expectancy. The study reported that if a quarter of HIV-positive individuals quit smoking, 265,000 years of life could be regained.
Specialists hope the study encourages more funding and access for HIV treatment that includes smoking cessation programs. Dr. Watkins-Hayes said the U.S. needs to ensure that all Americans, including economically disadvantaged people, can benefit from tools that help smokers quit.
"There have been so many advances in medicine to sustain life with HIV, and a good quality of life," said Newman. "Smoking needs to be part of the conversation."