Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition

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-...

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Main Authors: Olalekan A. Uthman, Anna Mia Ekström, Tahereh T. Moradi
Format: Article
Language:English
Published: BMC 2016-09-01
Series:BMC Public Health
Online Access:http://link.springer.com/article/10.1186/s12889-016-3637-1
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author Olalekan A. Uthman
Anna Mia Ekström
Tahereh T. Moradi
author_facet Olalekan A. Uthman
Anna Mia Ekström
Tahereh T. Moradi
author_sort Olalekan A. Uthman
collection DOAJ
description 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.
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spelling doaj.art-205161bff84448abbd62715f426095d52022-12-21T18:11:37ZengBMCBMC Public Health1471-24582016-09-011611910.1186/s12889-016-3637-1Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from compositionOlalekan A. Uthman0Anna Mia Ekström1Tahereh T. Moradi2Department of Public Health (IHCAR), Karolinska InstitutetDepartment of Public Health (IHCAR), Karolinska InstitutetInstitute of Environmental Medicine, Division of Epidemiology, Karolinska InstitutetAbstract 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.http://link.springer.com/article/10.1186/s12889-016-3637-1
spellingShingle Olalekan A. Uthman
Anna Mia Ekström
Tahereh T. Moradi
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
title Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition
title_full Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition
title_fullStr Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition
title_full_unstemmed Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition
title_short Influence of socioeconomic position and gender on current cigarette smoking among people living with HIV in sub-Saharan Africa: disentangling context from composition
title_sort influence of socioeconomic position and gender on current cigarette smoking among people living with hiv in sub saharan africa disentangling context from composition
url http://link.springer.com/article/10.1186/s12889-016-3637-1
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