Gender Differences in Smoking Behaviors are Narrowing but Health Impact is Wider in People Living with HIV

The widespread use of tobacco among people living with HIV (PLWH) has a significant impact on morbidity and mortality. However, gender differences in cigarette smoking and its consequences among PLWH have not been documented. For these analyses, we included 470 PLWH smokers (255 males and 215 females) actively followed in a randomized clinical trial. A comprehensive smoking and medical profile were obtained along with FEV 1 to assess if lung function and subsequent reduction differed by gender. Almost half of the participants were females (47%) and were slightly younger than their male counterparts (49±9 vs. 52±9 years, p=0.009). Smoking onset was similar (17±7 vs. 18±7 years of age, p=0.1), as well demonstrated preferences for mentholated cigarettes (women 89% vs. men 85%). Based on pulmonary function testing, females had a significantly lower percent predicted forced expiratory volume in one second (FEV1= 1.38) versus 1.9 in the male counterparts. Furthermore, women had a greater reduction in FEV1 over time. Among a clinical sample of PLWH smokers, we demonstrated significantly greater manifestations of lung damage in females compared to male smokers. Collectively, these findings further justify the need for more studies to closely monitor and tailor interventions for women.