Page 171 - HIVMED_v21_i1.indb

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 6 Original Research

Feasibility of implementing a novel behavioural

smoking cessation intervention amongst human

immunodeficiency virus-infected smokers in a

resource-limited setting: A single-arm pilot trial

Authors: Background: Tobacco use is prevalent amongst individuals infected with human
Billy M. Tsima 1 immunodeficiency virus (HIV). In resource-constrained settings, pharmacological smoking
Precious Moedi 2 cessation interventions are unfeasible because of their high cost. There is a need to develop and
Joyce Maunge 3
Kitso Machangane 3 evaluate behavioural interventions to address the unique challenges of tobacco use in the HIV-
Martha Kgogwane 3 infected populations in these settings.
Tebogo Mudojwa 3
Joseph Bastian 4 Objectives: The authors aimed to assess the feasibility and acceptability of the Behavioural
Warren Bilker 5 Activation/Problem Solving for Smoking Cessation (BAPS-SC) intervention programme to
Rebecca Ashare 4 determine whether it should be tested in an adequately powered randomised controlled trial.
Robert Schnoll 4
Robert Gross 6 Method: The authors merged behavioural activation therapy (BAT) with the principles of
problem-solving therapy to create a novel five-session counselling model to address the
Affiliations:
1 Department of Family unique challenges of tobacco cessation amongst those infected with HIV. Feasibility measures
Medicine and Public Health, included the rate of enrolment amongst those eligible and the retention rate and descriptive
Faculty of Medicine, analysis of intervention acceptability. The authors’ secondary outcome was 7-day point
University of Botswana, smoking prevalence abstinence, confirmed with breath carbon monoxide.
Gaborone, Botswana
Results: A total of 128 individuals were screened over 8 weeks with 50 deemed eligible and 40
2 Princess Marina Hospital, enrolled (80%). Retention at week 12 was 53% (21/40). The 7-day point prevalence abstinence,
Dental Department, co-confirmed, at week 12 was 37.5% (15/40). All respondents indicated that they would
Gaborone, Botswana
recommend BAPS-SC to other smokers who want to quit, and would be willing to participate
in the programme again up to the point of exit if they did not stop smoking.
3 Botswana UPenn
Partnership, Gaborone, Conclusion: A full-scale randomised control trial comparing BAPS-SC with usual practice is
Botswana
warranted to evaluate the efficacy of this novel intervention in these settings.
4 Department of Psychiatry, Keywords: smoking cessation; tobacco; behaviour activation; problem solving; HIV.
Perelman School of Medicine,
University of Pennsylvania,
Philadelphia, United States
of America Introduction
The human immunodeficiency virus (HIV) epidemic in sub-Saharan Africa has resulted in a
5 Department of Biostatistics,
1
Epidemiology and large-scale transformation of healthcare delivery in heavily affected countries such as Botswana.
Informatics, Perelman School Unfortunately, other health threats such as cardiovascular disease and cancer have emerged
of Medicine, University of amongst people living with HIV/AIDS (PLWHA) partly because of the chronic inflammation of
Pennsylvania, Philadelphia, 2
United States of America HIV that is compounded by high rates of smoking in this population. As such, addressing
modifiable cardiovascular risk factors amongst those with HIV infection, including tobacco use,
6 Department of Medicine has become a critical priority. 3,4
(ID), Perelman School of
Medicine, University of Indeed, continued smoking amongst those with HIV infection can result in serious adverse effects,
Pennsylvania, Philadelphia,
5
United States of America including reduced effectiveness of antiretroviral (ARV) therapy. Controlling for medication
adherence and comorbid illicit drug use, HIV-infected smokers on ARV have a significantly lower
Research Project Registration: likelihood of achieving a viral response and a greater chance of viral or immunologic failure
Project Number: HPDME
6
13/18/1 compared with their non-smoking counterparts. Persistent smoking amongst HIV-infected
7
individuals may also increase progression to acquired immunodeficiency syndrome (AIDS).
Read online: Corresponding author: Billy Tsima, [email protected]
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Scan this QR Dates: Received: 05 Feb. 2020 | Accepted: 08 Mar. 2020 | Published: 24 June 2020
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Copyright: © 2020. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
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