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People with HIV infection are more twice as likely to smoke cigarettes than people who do not have HIV. This high rate of smoking continues even though people with HIV are more susceptible to the negative effects of tobacco, including greater risk for conditions such as cancer, as well as cardiovascular and lung diseases. Importantly, smokers living with HIV (SLWH) say that they are less motivated to quit because smoking helps them control their emotions and many people in their social networks are smokers, which could lead to negative social consequences if they did quit. In contrast, having clear information about the specific effects of smoking in the context of HIV disease was noted to be a powerful motivator to quit. Given this background, investigating the social-emotional abilities that support social interaction, which is known as “social cognition,” in SLWH may identify problems that would be key areas to target in treatments for quitting smoking to enhance their success. In support of that idea, one type of social cognition problem, poor ability to identify and describe one’s feelings, has been linked to increased tobacco craving. Problems with other kinds of social cognition, including accurately reading the emotions and intentions of other people, have yet to be studied in relation to tobacco craving but have been linked to worse severity of addiction to alcohol and stimulants, suggesting they may be relevant in tobacco use as well. Also, both HIV and smoking can affect inflammation, which then contributes to multiple poor health outcomes. Social-emotional distress is related to higher inflammation; however, the exact nature of this relationship remains unknown in SLWH.
Therefore, this pilot proposal will examine social cognition in a group of people with and without HIV, half of whom will be current smokers. Social cognition will be assessed, and it is hypothesized that SLWH will have worse performance. This poor performance will be related to increased tobacco craving in the smokers, and this relationship will be stronger in SLWH. Markers of inflammation and the conditions that contribute to inflammation will be explored in blood samples. The goal of this study is to use the knowledge gained to tailor smoking cessation interventions for SLWH in ways that address their own stated needs. |
