The relationship of anxiety and smoking behaviors to medication adherence among cigarette smokers living with HIV

Introduction: People living with HIV/AIDS [PLWH] who smoke cigarettes report lower medication adherence. The purpose of the current study was to examine the relationship between anxiety and smoking behaviors (e.g., smoking quantity and frequency) and medication adherence in a sample of PLWH who smoke. Methods: PLWH who reported current cigarette smoking and use of antiretroviral medication were recruited from Center for Positive Living at Montefiore Medical Center (New York, US). Participants completed questions about their current smoking behavior, anxiety symptoms, and medication adherence. Results: The analytic sample included sixty-eight PLWH who smoked cigarettes (female 48.5%, mean age = 49.1 ± 8.8 years, 52.2% Latino/a). The participants smoked an average of 10.53 (SD = 8.6) cigarettes daily and just over half of participants (55.9%) reported high medication adherence. There was a significant association between greater anxiety symptoms and poorer medication adherence (OR = 1.09, CI = 1.04–1.15, p = .001). Participants with higher anxiety symptoms were more likely to report forgetting to take their medication, forgetting to take medication when leaving on a trip, stopping medication when feeling symptoms are under control, and when feeling hassled about sticking to the treatment plan. Within this sample of current smokers, there were no significant associations between smoking quantity or frequency and medication adherence and no interactive effects of these smoking behaviors and anxiety on medication adherence. Discussion: Current cigarette smoking PLWH who reported greater anxiety symptoms were less likely to adhere to their medication than current smoking PLWH who reported fewer anxiety symptoms. PLWH who smoke may benefit from assessment and management of anxiety.