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. 2025 Jul 24.
doi: 10.1007/s10461-025-04823-7. Online ahead of print.

WeChat-based Messaging and Behavioral Counseling for Smoking Cessation for People with HIV in China: a Randomized Controlled Pilot Trial

Jiegang Huang #  1   2 , Shanyin Yang #  3 , Zhiman Xie  4 , Baodong Guo  1   2 , Yingji Lan  1   2 , Yanjun Li  4 , Yuan Jiang  5 , Leah S Forman  6 , Karsten Lunze  3 , Bingyu Liang  1   2 , Abu S Abdullah  3 , Li Ye  2   7   8 , Hao Liang #  2   7   8 , Lisa M Quintiliani #  9
Affiliations

WeChat-based Messaging and Behavioral Counseling for Smoking Cessation for People with HIV in China: a Randomized Controlled Pilot Trial

Jiegang Huang et al. AIDS Behav. .

Abstract
in English, Spanish

Cigarette smoking among people with HIV is a leading preventable cause of morbidity and mortality, particularly in China given its immense burden of smoking. This pilot study aimed to evaluate the feasibility, acceptability, and efficacy on smoking cessation of a community-informed WeChat-based messaging and behavioral counseling intervention for people with HIV who smoke called Quit for Life. The study design was a 2-group randomized clinical trial. Data collection occurred between February 2022 and August 2023 within a tertiary infectious disease hospital in Nanning city, Guangxi, China. Participants included adults with HIV who smoked, were willing to set a quit date, and received HIV care at the hospital. Participants were randomized to the 8-week Quit for Life intervention group (nicotine replacement therapy gum, self-help quitting smoking guide, behavioral counseling, and WeChat-based messaging), or the control group (nicotine replacement therapy gum and self-help guide only). Complete case analysis was performed. Of 219 people assessed for eligibility, 109 participants were randomized (mean [SD] age, 45.3 [15.1] years; men [96.3%]) and 98 completed the 12-week assessment (89.9% retention rate). At 12-week follow-up, the biochemically verified smoking cessation rate (primary outcome) was significantly higher in the intervention group compared to the control group (59.1% abstinence vs. 25.6%, adjusted odds ratio 5.3 [1.5,19.2]. Implementation and feasibility metrics indicated most participants receiving the intervention as intended gave high ratings of the usefulness of counseling sessions and WeChat-based messaging. Given these findings, subsequent studies should investigate implementation and scale-up of this intervention for people with HIV in China.Clinical trial registration details: Trial registration number: ClinicalTrials.gov Identifier: NCT05020899. Date of trial registration: 8-19-2021.

El tabaquismo entre las personas con VIH es una de las principales causas prevenibles de morbilidad y mortalidad, particularmente en China dada su inmensa carga de tabaquismo. Este estudio piloto tuvo como objetivo evaluar la viabilidad, aceptabilidad y eficacia para dejar de fumar de una intervención de mensajería y asesoramiento conductual basada en WeChat e informada por la comunidad para personas con VIH que fuman, llamada Quit for Life. El diseño del estudio fue un ensayo clínico aleatorizado de 2 grupos. La recopilación de datos se realizó entre febrero de 2022 y agosto de 2023 en un hospital terciario de enfermedades infecciosas en la ciudad de Nanning, Guangxi, China. Los participantes incluyeron adultos con VIH que fumaban, estaban dispuestos a fijar una fecha para dejar de fumar y recibían atención para el VIH en el hospital. Los participantes fueron asignados aleatoriamente al grupo de intervención Quit for Life de 8 semanas (chicles de terapia de reemplazo de nicotina, guía de autoayuda para dejar de fumar, asesoramiento conductual y mensajería basada en WeChat), o al grupo de control (solo chicles de terapia de reemplazo de nicotina y guía de autoayuda). Se realizó un análisis de casos completos. De 219 personas evaluadas para determinar su elegibilidad, 109 participantes fueron aleatorizados (edad media [DE], 45,3 [1,15] años; hombres [96,3%]) y 98 completaron la evaluación de 12 semanas (tasa de retención del 89,9%). En el seguimiento de 12 semanas, la tasa de abandono del tabaco verificada bioquímicamente (resultado primario) fue significativamente mayor en el grupo de intervención en comparación con el grupo de control (59,1% de abstinencia frente a 25,6%, razón de momios ajustada 5,3 [1, 2, 5, 19]). Las métricas de implementación y viabilidad indicaron que la mayoría de los participantes que recibieron la intervención según lo previsto otorgaron altas calificaciones a la utilidad de las sesiones de asesoramiento y la mensajería basada en WeChat. Dados estos hallazgos, estudios posteriores deberían investigar la implementación y la ampliación de esta intervención para personas con VIH en China.

Keywords: Behavioral counseling; HIV; Smoking cessation; WeChat.

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Conflict of interest statement

Declarations. Competing Interests: The authors have no relevant financial or non-financial interests to disclose. Ethics Approval: This study was performed in line with the principles of the Declaration of Helsinki. Study procedures were approved by the Institutional Review Boards of Boston University Medical Campus and the Guangxi Medical University. Informed consent was obtained from all subjects.

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