Uthman, Olalekan A., Ekström, Anna Mia and Moradi, Tahereh (2016) Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa : disentangling context from composition. BMC Public Health, 16 . 998. ISSN 1471-2458.

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Abstract

Background: Smoking is still gaining ground in Sub-Saharan Africa, especially among socially disadvantaged groups. People living with HIV represent a subgroup with a significantly elevated prevalence of cigarette smoking. The objective of the study was to examine the influence of individual-, neighbourhood- and country-level socioeconomic position on current cigarette smoking among people living with HIV in Sub-Saharan Africa.

Methods: We applied multivariable multilevel logistic regression analysis on Demographic and Health Survey data collected between 2003 and 2012 in sub-Saharan Africa. We identified 31,270 individual living with HIV (Level 1) nested within 7,054 neighbourhoods (Level 2) from 19 countries (Level 3).

Results: After adjustment for individual-, neighbourhood- and country-level factors, respondents, the following significant independent risk factors for increasing odds of being a current cigarette smokers among people living with HIV: male gender (odds ratio [OR] = 62.49; 95% credible interval [CrI] 45.93 to 78.28), from the poorer households (OR = 1.62, 95% CrI 1.38 to 1.90); living in urban areas (OR = 1.24, 95% CrI 1.09 to 1.41), from neighbourhoods with low poverty rate (OR = 1.25, 95% CrI 1.09 to 1.43), illiteracy rate (OR = 1.28, 95% CrI 1.14 to 1.42), low unemployment rate (OR = 1.11, 95% crI 1.01 to 1.43); and from countries with low socio-economic deprivation (OR = 1.53, 95 CrI 1.08 to 1.96). About 3.4% and 39.4% variation in cigarette smoking behaviour among people living with HIV is conditioned by differences between neighbourhoods and countries.

Conclusions: Gender, education and socioeconomic context are independently associated with current cigarette smoking among people living with HIV in sub-Saharan Africa.

Item Type:	Journal Article
Subjects:	D History General and Old World > DT Africa H Social Sciences > HN Social history and conditions. Social problems. Social reform H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Smoking--Africa, Sub-Saharan, HIV-positive persons, HIV-positive persons--Africa, Sub-Saharan--Economic conditions
Journal or Publication Title:	BMC Public Health
Publisher:	BioMed Central Ltd.
ISSN:	1471-2458
Official Date:	20 September 2016
Dates:	Date Event 20 September 2016 Published 26 August 2016 Accepted 3 February 2016 Submitted
Volume:	16
Article Number:	998
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	5 September 2016
Date of first compliant Open Access:	20 October 2016
Funder:	Forskningsrådet för hälsa, arbetsliv och välfärd
Grant number:	2012-0064

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