"I Thought Cancer was a Tobacco Issue": Perspectives of Veterans with and without HIV on Cancer and Other Health Risks Associated with Alcohol and Tobacco/Nicotine Use

doi:10.1007/s10461-024-04363-6

. 2024 Aug;28(8):2607-2618.

doi: 10.1007/s10461-024-04363-6. Epub 2024 Jun 13.

"I Thought Cancer was a Tobacco Issue": Perspectives of Veterans with and without HIV on Cancer and Other Health Risks Associated with Alcohol and Tobacco/Nicotine Use

Elsa S Briggs^{1

2}, Rachel M Thomas³, Madeline C Frost^{3

4}, Olivia V Fletcher³, Kristina Crothers^{3

5}, Clementine K Chalal³, Shahida F Shahrir^{3

5

6}, Jennifer B McClure^{7

8}, Sheryl L Catz⁹, Emily C Williams^{3

4}

Affiliations

¹ Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA. [email protected].
² Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA. [email protected].
³ Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA.
⁴ Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
⁵ Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA, USA.
⁶ Center for Health Workforce Studies, Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA.
⁷ Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
⁸ Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
⁹ Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA.

PMID: 38869757
PMCID: PMC12126058 (available on 2025-08-01)
DOI: 10.1007/s10461-024-04363-6

"I Thought Cancer was a Tobacco Issue": Perspectives of Veterans with and without HIV on Cancer and Other Health Risks Associated with Alcohol and Tobacco/Nicotine Use

Elsa S Briggs et al. AIDS Behav. 2024 Aug.

. 2024 Aug;28(8):2607-2618.

doi: 10.1007/s10461-024-04363-6. Epub 2024 Jun 13.

Authors

Affiliations

¹ Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA. [email protected].
² Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA. [email protected].
³ Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA.
⁴ Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
⁵ Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA, USA.
⁶ Center for Health Workforce Studies, Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA.
⁷ Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
⁸ Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
⁹ Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA.

PMID: 38869757
PMCID: PMC12126058 (available on 2025-08-01)
DOI: 10.1007/s10461-024-04363-6

Abstract

U.S. Veterans and people living with HIV (PWH) experience higher rates of unhealthy alcohol and tobacco/nicotine use than non-Veterans and people without HIV (PWoH). Both groups are susceptible to adverse health outcomes associated with alcohol and tobacco/nicotine use. We explored awareness of alcohol- and tobacco/nicotine-related cancer and immune health risks among Veterans Health Administration (VA) patients with and without HIV. Among a sample of 41 (46% PWH; 73% male; 39% Black) purposively-selected VA patients receiving care 2020-2021 we conducted semi-structured interviews via telephone; interviews were recorded, transcribed and analyzed using a Rapid Assessment Process. Purposive selection was based on HIV status, alcohol and/or tobacco/nicotine use, and demographics. Among participants, 66% reported current smoking, and most screened positive for unhealthy alcohol use. Participants had high awareness of cancer and other health risks related to smoking but low awareness of synergistic risks and cancer risks associated with alcohol use despite awareness of a range of other alcohol-related risks. Awareness of alcohol and/or tobacco/nicotine's impacts on the immune system was variable. Findings did not distinctly differ between PWH and PWoH. Low awareness of alcohol-related cancer risk, risks of co-occurring use, and varying awareness of the impacts of alcohol and tobacco/nicotine on the immune system suggest a need for improved messaging regarding substance use-related cancer and immune risk. This may be especially important among PWH, for whom the prevalence and adverse effects of alcohol and tobacco use, and immune dysfunction are higher.

Keywords: Alcohol use; Cancer; HIV; Smoking; Tobacco/nicotine use; Veterans.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

The authors declare that they have no conflicts of interest.

References

1. Pathai S, Bajillan H, Landay AL, High KP. Is HIV a model of accelerated or accentuated aging? J Gerontol A Biol Sci Med Sci. 2014;69(7):833–842. doi:10.1093/gerona/glt168 - DOI - PMC - PubMed
1. Guaraldi G, Orlando G, Zona S, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis Off Publ Infect Dis Soc Am. 2011;53(11):1120–1126. doi:10.1093/cid/cir627 - DOI - PubMed
1. Jimenez Z, Sanchez-Conde M, Brañas F. HIV infection as a cause of accelerated aging and frailty. Rev Espanola Geriatr Gerontol. 2018;53(2):105–110. doi:10.1016/j.regg.2017.04.007 - DOI - PubMed
1. Wing EJ. HIV and aging. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2016;53:61–68. doi:10.1016/j.ijid.2016.10.004 - DOI - PubMed
1. Currier JS, Havlir DV. Complications of HIV disease and antiretroviral therapy. Top HIV Med Publ Int AIDS Soc USA. 2009;17(2):57–67. - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
- Springer
Medical
- MedlinePlus Health Information

[1] Pathai S, Bajillan H, Landay AL, High KP. Is HIV a model of accelerated or accentuated aging? J Gerontol A Biol Sci Med Sci. 2014;69(7):833–842. doi:10.1093/gerona/glt168 - DOI - PMC - PubMed

[2] Pathai S, Bajillan H, Landay AL, High KP. Is HIV a model of accelerated or accentuated aging? J Gerontol A Biol Sci Med Sci. 2014;69(7):833–842. doi:10.1093/gerona/glt168 - DOI - PMC - PubMed

[3] Guaraldi G, Orlando G, Zona S, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis Off Publ Infect Dis Soc Am. 2011;53(11):1120–1126. doi:10.1093/cid/cir627 - DOI - PubMed

[4] Guaraldi G, Orlando G, Zona S, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis Off Publ Infect Dis Soc Am. 2011;53(11):1120–1126. doi:10.1093/cid/cir627 - DOI - PubMed

[5] Jimenez Z, Sanchez-Conde M, Brañas F. HIV infection as a cause of accelerated aging and frailty. Rev Espanola Geriatr Gerontol. 2018;53(2):105–110. doi:10.1016/j.regg.2017.04.007 - DOI - PubMed

[6] Jimenez Z, Sanchez-Conde M, Brañas F. HIV infection as a cause of accelerated aging and frailty. Rev Espanola Geriatr Gerontol. 2018;53(2):105–110. doi:10.1016/j.regg.2017.04.007 - DOI - PubMed

[7] Wing EJ. HIV and aging. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2016;53:61–68. doi:10.1016/j.ijid.2016.10.004 - DOI - PubMed

[8] Wing EJ. HIV and aging. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2016;53:61–68. doi:10.1016/j.ijid.2016.10.004 - DOI - PubMed

[9] Currier JS, Havlir DV. Complications of HIV disease and antiretroviral therapy. Top HIV Med Publ Int AIDS Soc USA. 2009;17(2):57–67. - PubMed

[10] Currier JS, Havlir DV. Complications of HIV disease and antiretroviral therapy. Top HIV Med Publ Int AIDS Soc USA. 2009;17(2):57–67. - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

"I Thought Cancer was a Tobacco Issue": Perspectives of Veterans with and without HIV on Cancer and Other Health Risks Associated with Alcohol and Tobacco/Nicotine Use

Affiliations

"I Thought Cancer was a Tobacco Issue": Perspectives of Veterans with and without HIV on Cancer and Other Health Risks Associated with Alcohol and Tobacco/Nicotine Use

Authors

Affiliations

Abstract

Conflict of interest statement

Similar articles

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Abstract

Conflict of interest statement

Similar articles

References

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Medical