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Long-term follow-up of smokers living with HIV after an intensive behavioral tobacco treatment intervention.

吸烟伴 HIV 感染者在强化行为烟草治疗干预后的长期随访。

  • 影响因子:3.24
  • DOI:10.1097/QAI.0000000000002330
  • 作者列表:"Shuter J","Kim RS","Durant S","Stanton CA
  • 发表时间:2020-02-14
Abstract

INTRODUCTION:Cigarette smoking is extremely common among persons living with HIV (PLWH) in the United States, and it has emerged as a leading killer in this group. No tobacco treatment studied to date has demonstrated long-term efficacy. METHODS:This was a follow-up study of PLWH adult smokers who completed a randomized controlled trial of Positively Smoke Free (PSF) group therapy from 2014 to 2017. Participants from two of the three trial sites were recalled to complete a long-term follow-up assessment, at least one year after initial enrollment. RESULTS:Of the 342 candidates for this follow-up study, 11 had died prior to our attempts to contact them, and 194 of the remaining 331 (58.6%) completed the late follow-up assessment. Most (91.2%) of the remaining candidates could not be contacted despite numerous attempts. At a mean of 38.1 months after initial study enrollment, employing an intention-to-treat, lost to follow-up=still smoking (worst case scenario) strategy, 12.7% of group therapy vs. 6.6% of control participants had biochemically-verified 7-day point-prevalence abstinence, OR=2.06 (95% CI:0.96-4.41), P=0.06, and 10.3% of group therapy vs. 4.2% of control participants had biochemically-verified 12-month point-prevalence abstinence, OR=2.61 (95% CI: 1.05-6.47, P=0.03). Improvements in abstinence self-efficacy in the PSF group observed in the original study were sustained through late follow-up. CONCLUSIONS:Targeted group therapy for PLWH smokers was associated with increased cessation and sustained improvements in abstinence self-efficacy at a mean of more than three years of follow-up. This is the first trial to show long-term efficacy of tobacco treatment for PLWH.

摘要

引言: 在美国,吸烟在 HIV 感染者 (PLWH) 中极为常见,它已成为这一群体的主要杀手。到目前为止,还没有研究过烟草治疗表现出长期疗效。 方法: 这是一项针对 PLWH 成年吸烟者的随访研究,他们于 2014年 (2017年) 完成了积极无烟 (PSF) 组治疗的随机对照试验。来自三个试验地点中的两个的参与者被召回,以完成长期随访评估,至少在首次入组后一年。 结果: 在这项后续研究的 342 名候选人中,有 11 人在我们试图联系他们之前死亡,其余 194 人中的 331 人 (58.6%) 完成后期随访评估。尽管多次尝试,仍无法联系到其余候选人中的大多数 (91.2%)。在初始研究入组后平均 38.1 个月,采用意向治疗,失访 = 仍吸烟 (最坏情况) 策略,12.7% 的群体治疗 vs. 6.6% 的对照参与者进行了生化验证的 7 天点患病率戒断,OR = 2.06 (95% CI: 0.96-4.41),P = 0.06,10.3% 的群体治疗 vs.4.2% 的对照参与者进行了生物化学验证的 12 个月点患病率戒断,OR = 2.61 (95% CI: 1.05-6.47,P = 0.03)。原始研究中观察到的 PSF 组戒断自我效能的改善通过后期随访得以持续。 结论: 在平均 3 年以上的随访中,PLWH 吸烟者的靶向团体治疗与戒烟增加和戒断自我效能持续改善相关。这是首次显示烟草治疗对 PLWH 长期疗效的试验。

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METHODS::Minimally invasive surgery for complex endometriosis requires preoperative planning that intimately connects the gynecologic surgeon to the radiologist. Understanding the surgeon's perspective to endometriosis treatment facilitates a productive relationship that ultimately benefits the patient. We examine minimally invasive surgery for endometriosis and the key radiologic information which enable the surgeon to successfully negotiate patient counseling, preoperative planning, and an interdisciplinary approach to surgery.

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