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Smoking Increases Risk of HIV Acquisition

one of these also found that smokers had an increased risk of developing AIDS-related dementia, but it also found that smoking was protective against the AIDS-defining cancer, Kaposi’s sarcoma.

“The studies identified in this systematic review indicate that while smoking might be independently associated with acquiring HIV, it does not appear to be related to progression to AIDS”, write the investigators. They add, “the consistency of the findings is striking and represents a major strength of this review.”

But the investigators’ analysis highlighted a need for more research into these issues. They write, “further research is needed to investigate whether the association between smoking and HIV seroconversion is related to residual confounding.”

Additional research is also needed to see if smoking is causing “intercurrent illness, which could contribute to general debilitation and progression to AIDS”, such as bacterial pneumonia and tuberculosis in resource-limited countries. Furthermore, research is needed to see if there is a link between smoking and lipid abnormalities and cardiovascular disease in patients taking antiretrovirals.

“The public health message on smoking remains clear - tobacco is not good for health”, conclude the investigators. However, they acknowledge that stopping smoking may not be a priority for many HIV-positive individuals - some of the groups most at risk of HIV, particularly gay men and sex workers, have high rates of smoking and in many countries these groups are marginalised and it is difficult to offer any sort of support, “let alone smoking cessation services.”

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