1. Smoking and Cessation Among Men Who Have Sex with Men in
Baltimore, 2011
Kyle W. Prier
May 18, 2014
Introduction
Tobacco use continues to be a tremendous public
health concern in the United States. Approximately
19.3% of adults in the US are smokers, with tobacco use
being the leading cause of preventable death and disease
in the United States 1
. Additionally, tobacco use was the
leading cause of all mortality in the United States in 2000
with approximately 435,000 annual deaths, representing
18.1% of all mortality for the year 2
. However, smoking
rates among adults in the US have been declining
consistently over the last several decades, with 42.4% of
adults in 1965 being smokers compared to 19.3% today
3
. Despite significant success in tobacco control efforts in
reducing smoking rates, the negative effects of tobacco
use continue to disparately impact various geographic
and socio-demographic subgroups 4-6
. Regarding sexual
identity and tobacco use, there is evidence that smoking
and tobacco use rates are disproportionately higher
among lesbian, gay, and bisexual (LGB) population
groups 7, 8
. Additionally, several studies have identified
higher rates of tobacco use among persons living with
HIV/AIDS (PLHIV) and others at increased risk for
HIV/AIDS 9-11
.
In contrast with declining smoking rates among adults
in the US, since the early 1990s there has been a steady
increase in HIV infection rates particularly among men
who have sex with men (MSM). Currently new HIV
infections among MSM account for over half of all new
infections 12
. While the CDC reports that approximately
4 percent of men in the US are MSM, the rate of diagnosis
of HIV infections among MSM is more than 44 times
higher than other men 13
. In order to better understand and
address the HIV epidemic in the US, the Centers for
Disease Control and Prevention implements the National
HIV Behavioral Surveillance System (NHBS), which
involves serial cross-sectional data collection among
injection drug users, heterosexuals at high risk for HIV,
and MSM in areas with particularly high HIV infection
including the city of Baltimore14
.
The objective of this current study is to describe the
demographic, sexual and drug use characteristics and
proportion of current, former, and non-smokers in a
sample of MSM from Baltimore, Maryland.
Methods
Procedures
NHBS-MSM sampling and methods have been
described previously 14-16
. Venue-based data collection
among MSM in Baltimore were carried out in three
waves. The first was conducted between June 2004 and
April 2005, the second between July and October 2008,
and the third in 2011. Protocols were identical for all
three waves. Prior to each wave, extensive formative
research was conducted in the form of focus groups with
MSM and interviews with community informants and
public health practitioners in order to identify current and
private venues (e.g., bars, clubs, businesses, events,
neighborhood locations) that are frequently visited by
MSM in Baltimore and high-traffic day/time periods for
study recruitment. Sampling frames were then
determined from venues and day/time recruitment
periods and 15 or more venue-day-time periods, or
sampling events, were randomly chosen and scheduled
for each month for recruitment. Sampling events
averaged 18 per month in all three waves.
During each venue-day-time period, recruiters
systematically selected and approached men who crossed
a predetermined intercept location at the event, after
which candidates were judged for study eligibility.
Eligible participants were: males 18 years or older,
Baltimore-Towson metropolitan area residents, and had
not previously participated in the current data collection
wave; sexual identity or practice did not preclude men
from being eligible. Eligible men completed study
procedures either on site in a nearby mobile unit or in
study offices at a later scheduled time. Consent was
provided orally and documented by trained interviewers.
Consent for HIV testing was given independently and
was not prerequisite for study participation. Upon
successful completion of informed consent procedures,
participants were interviewed using a handheld

2. computer-assisted standard questionnaire, provided
serum sample for HIV testing, received counseling and
given referral to prevention services, and received US
$50 for time reimbursement. Study protocol and
materials were reviewed and approved by the Maryland
Department of Health and Mental Hygiene and The Johns
Hopkins Bloomberg School of Public Health Institutional
Review Boards.
Measures
The standardized NHBS survey questionnaire
includes demographics, HIV sexual and drug use risk
behaviors, medical history, and sexual identity.
Race/ethnicity was categorized as non-Hispanic White,
African-American, Hispanic, Native American, Pacific
Islander, Asian-American, or of mixed race/ethnicity
(self-reported being more than one race/ethnicity).
Because of small numbers of Hispanic, Native American,
Pacific Islander, Asian-American, and mixed
race/ethnicity, participants were analyzed according to
race/ethnicity categories of non-Hispanic White,
African-American, and “other”. Education was reported
as highest level attained at the time of survey. Recent
sexual risk behaviors included total number of male sex
partners (categorized to reflect quartile), sex with men
only or sex with men and women (i.e., identity), and
unprotected anal intercourse (UAI). UAI was defined as
not using a condom during one or more sex acts in the
last year. Lifetime variables of homelessness, arrest or
held by law enforcement, injection drug use (IDU), and
non-injection drug use (non-IDU). Participants who
responded “yes” to the question regarding ever smoking
tobacco products were asked if they currently smoked.
These two variables were combined into a categorical
variable of “current, former, and non-smokers.”
Blood specimens determined with sufficient volume
were tested for HIV-1 antibodies by the Maryland
Department of Health and Mental Hygiene Laboratories
Administration with a US Food and Drug
Administration-licensed enzyme immunoassay.
Repeatedly reactive samples were confirmed using
Western blot by The Maryland Department of Health and
Mental Hygiene Laboratory.
Analyses
Univariate analyses were conducted for smoking and
each demographic, sexual, and drug use variable.
Bivariate associations with smoking and each variable
were assessed using Chi square tests and unadjusted odds
ratios (i.e., Relative Risk Ratios) were computed.
Variables found to be associated with smoking were
entered in a multinomial logistic regression. Analyses
were conducted in STATA 12. Odds ratios for each
categorical variable were computed with non-smokers as
the referent outcome.
Results
Sample Characteristics
Table 1 displays the demographics and sample
characteristics of the MSM who reported smoking status.
The majority of respondents (91.2 %) were African
American, while 14.4 % were White and 8.8 % were
some other race or ethnicity. Over a third (34.1 %) of the
sample were between 18 and 24 years old. 44.4 % of
MSM in the study had completed some education more
than grade 12. Over 34 % of participants earned less than
$10,000 a year and over 22 % had a household income of
more than $40,000. Over 16 % of the respondents
indicated they had been homeless before, and 6.8 % of
MSM indicated they were currently homeless. Under half
(44.1 %) of respondents had been arrested or held by law
enforcement previously, while over 13 % of all
respondents had been held or arrested within the past 12
months.
Smoking status
Table 1 indicates smoking characteristics among
MSM in Baltimore. The majority of MSM in Baltimore
(60.4 %) indicated they were current smokers. Under a
quarter (24.6 %) of the respondents had never smoked
before and less than 15 % of MSM were former smokers.
Sexual and Drug Use Behavior
Table 1 also presents sexual and drug use behaviors
among MSM in Baltimore. Less than a third of MSM
(27.3 %) indicated one male sexual partner in the last 12
months, while 10.6 % had 9 or more partners. Over 37 %
of MSM had 2 to 3 male partners within the last year.
Less than a quarter (23.7 %) of MSM in Baltimore
reported their sexual identity as bisexual, the remaining
77.3 % identified as homosexual. The majority of MSM
in Baltimore (76.8 %) indicated that within the past year
they had not engaged in unprotected anal intercourse
(UAI). Regarding drug use behavior, only 8.6 % of MSM
in Baltimore had ever injected drugs and only 2.7 % of
MSM had injected any drug within the past year. Over
half (50.3 %) of all MSM indicated non injection drug
use within the past 12 months.
HIV testing, status, and access to healthcare
Table 1 also indicates respondents’ HIV test results
and status as well as factors relating to healthcare access.
The majority of MSM in Baltimore (91.0 %) had been
tested for HIV previously, and over half (52.8 %) of
MSM had been tested for HIV within the past year.
Regarding HIV test results as part of this study, 28.8 %
of MSM in the study were newly diagnosed as HIV

3. positive, 12.8 % were previously diagnosed HIV
positive, and 58.4 % of MSM received negative HIV test
results. 41.6 % of MSM in Baltimore were PLHIV. The
majority (72 %) of MSM had current health insurance
coverage and over 80 % of respondents had visited a
doctor’s office in the past year.
Tests of Association
Table 2 presents the bivariate relationships of the
demographic, sexual, and drug use risk variables with
current smoking status. Significant associations were
found between smoking and the demographic measures
of race, age, education, homelessness and arrest by law
enforcement. African-Americans were less likely to quit
smoking (OR = 0.20) than White respondents.
Age group
Respondents between the ages of 25 and 34 years
were over twice as likely to smoke (OR = 2.19) and
almost three times as likely to have quit smoking (OR =
2.92) than MSM in the 18 to 24 year age category.
Additionally, those in the 35 to 44 age group were more
likely to be current smokers (OR = 2.31) than those in the
18 to 24 year age group. MSM in the 45 to 54 age group
were even more likely to be current smokers (OR = 3.8)
than those in the 18 to 24 age group. However, those in
the 55+ age group were over 3 times more likely to have
quit smoking (OR = 3.19) than those in the in the 18 to
24 age group.
Education, Homelessness, Arrest, and Income
Although income was not found to be significantly
related to smoking status, education, homelessness and
arrest rates were. MSM that completed Grade 12 were
less likely to be current smokers (OR = 0.19) than those
who completed less than grade 12. Those who completed
more than grade 12 were also less likely to be current
smokers (OR = 0.13) than those who completed less than
grade 12. The odds of MSM who have been homeless to
be a current smoker were 6.26 times higher than that of
participants who have never been homeless. Of the 70
participants who had ever been homeless, 7.0 % were
non-smokers and 87.3 % were current smokers. MSM
who have ever been arrested or held were 5.26 times
likely to be current smokers than those who have never
been arrested. Current smokers were more likely to have
ever been arrested (78.1 %).
Sexual and drug use risk behavior and smoking status
The number of male sex partners in the last year and
sexual identity were significantly associated with
smoking status. MSM with 4 to 8 male sex partners in the
last year were twice as likely (OR = 2.00) to smoke and
over 3.3 times more likely (OR = 3.38) to quit smoking
than MSM with only one male sex partner in the last year.
MSM who reported UAI with casual partner(s) in the last
year were 2.4 times more likely (OR = 2.41) to have quit
smoking than MSM that reported no UAI in the last year.
Non injection drug use and IDU in the last 12 months
were both related to smoking. MSM that reported non
IDU use in the last year and smoked (73.5 %) were 3.79
times more likely to smoke than the 59.1 % of smokers
that did not use non injection drugs.
Full Model
A multinomial logistic regression model was
constructed that included all variables that were found to
be significantly associated with smoking status in the
bivariate analyses. Because several variable pairs were
collinear and were measures of the same relationship, one
corresponding variable from each pair was omitted from
the final model. The collinear variable pairs were
currently/ever homeless, ever/in last 12 months held or
arrested, ever/in last 12 months injected drug use. The
variables currently homeless, held or arrested in last 12
months, and IDU in last 12 months were omitted from the
final model. This model showed significant effects for
race, age, education, homelessness, arrest, and number of
male sex partners (see Table 3). After controlling for
other covariates, MSM in the 25-34 age group were 2.26
times more likely to smoke and 2.55 times more likely to
have quit smoking than those in 18-24 age group.
Additionally, MSM in the 45-54 age group were 4.01
times more likely to smoke than those in the 18-24 age
group. After controlling for other covariates, sexual
identity, UAI, and injection drug use did not significantly
add to the model. While non-IDU did not significantly
add to the fit of the model (χ2
= 10.25, p = 0.0059) the
odds for current smokers to have used non injection drugs
in the past year was 2.46 times higher than for non-
smokers.

4. References
1. Centers for Disease Control and Prevention (CDC). Vital
signs: Current cigarette smoking among adults aged
>/=18 years--united states, 2005-2010 MMWR Morb
Mortal Wkly Rep 2011 Sep 9;60(35):1207-12.
2. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual
causes of death in the united states, 2000 Jama 2004 Mar
10;291(10):1238-45.
3. Garrett BE, Dube SR, Trosclair A, Caraballo RS, Pechacek
TF. Cigarette Smoking—United states, 1965–2008.
MMWR Surveill Summ 2011;60(1):109-13.
4. King BA, Dube SR, Tynan MA. Current tobacco use among
adults in the united states: Findings from the national
adult tobacco survey. Am J Public Health
2012;102(11):e93-e100.
5. Ellickson PL, Orlando M, Tucker JS, Klein DJ. From
adolescence to young adulthood: Racial/ethnic
disparities in smoking. Am J Public Health 2004
Feb;94(2):293-9.
6. Cokkinides VE, Halpern MT, Barbeau EM, Ward E, Thun
MJ. Racial and ethnic disparities in smoking-cessation
interventions: Analysis of the 2005 national health
interview survey. Am J Prev Med 2008;34(5):404-12.
7. Gruskin EP, Greenwood GL, Matevia M, Pollack LM, Bye
LL. Disparities in smoking between the lesbian, gay,
and bisexual population and the general population in
california. Am J Public Health 2007;97(8):1496-502.
8. Cochran SD, Bandiera FC, Mays VM. Sexual orientation-
related differences in tobacco use and secondhand
smoke exposure among US adults aged 20 to 59 years:
2003-2010 national health and nutrition examination
surveys Am J Public Health 2013 Oct;103(10):1837-44.
9. Duval X, Baron G, Garelik D, Villes V, Dupre T, Leport C,
Lert F, Peretti-Watel P, Ravaud P, Spire B, et al. Living
with HIV, antiretroviral treatment experience and
tobacco smoking: Results from a multisite cross-
sectional study. Antivir Ther 2008;13(3):389-97.
10. Mamary EM, Bahrs D, Martinez S. Cigarette smoking and
the desire to quit among individuals living with HIV.
AIDS Patient Care STDS 2002;16(1):39-42.
11. Robinson W, Brown M, Moody-Thomas S. Smoking and
experiences with tobacco cessation among men who
have sex with men: New orleans, 2011. AIDS and
Behavior 2014;18(3):324-32.
12. Hall HI, Song R, Rhodes P, Prejean J, An Q, Lee LM,
Karon J, Brookmeyer R, Kaplan EH, McKenna MT, et
al. Estimation of HIV incidence in the united states Jama
2008 Aug 6;300(5):520-9.
13. Centers for Disease Control and Prevention. Estimated
HIV Incidence in the United States, 2007–2010.HIV
Surveillance Supplemental Report 2012; 17 (no.4) 2012.
14. Gallagher KM, Sullivan PS, Lansky A, Onorato IM.
Behavioral surveillance among people at risk for HIV
infection in the U.S.: The national HIV behavioral
surveillance system. Public Health Rep 2007;122 Suppl
1:32-8.
15. Centers for Disease Control and Prevention (CDC).
Prevalence and awareness of HIV infection among men
who have sex with men --- 21 cities, united states, 2008.
MMWR Morb Mortal Wkly Rep 2010 Sep
24;59(37):1201-7.
16. MacKellar DA, Gallagher KM, Finlayson T, Sanchez T,
Lansky A, Sullivan PS. Surveillance of HIV risk and
prevention behaviors of men who have sex with men--a
national application of venue-based, time-space sampling.
Public Health Rep 2007;122 Suppl 1:39-47.

5. Table 1 Sample characteristics of MSM Baltimore
N %
Sociodemographic
Race
White, not Hispanic 64 14.4
Black, not Hispanic 341 91.2
Other 39 8.8
Age (years)
18 – 24 148 33.3
25 – 34 114 25.7
35 – 44 76 17.1
45 – 54 81 18.2
55+ 25 5.6
Highest level of education completed
Less than grade 12 58 13.1
Grade 12 or GED 188 42.4
More than grade 12 197 44.5
Income
< $10,000 144 34.1
$10,000 - $19,999 89 21.1
$20,000 - $39,999 96 22.8
>$40,000 93 22.0
Currently Homeless
No 411 93.2
Yes 30 6.8
Ever Homeless
No 370 83.9
Yes 71 16.1
Ever held or arrested
No 248 55.9
Yes 196 44.1
Held or arrested in past 12 months
No 385 86.7
Yes 59 13.3
Smoking status
Non-smokers 109 24.6
Current smokers 268 60.4
Former smokers 67 15.1
Sexual behaviors
No. of male sex partners in last 12
months
One 121 27.3
2 to 3 166 37.4
4 to 8 110 24.8
9 or more 47 10.6
In past 12 months, any sex with
Men only 339 76.4
Men and women 105 23.7
In past 12 months any UAI with
No UAI 340 76.8
Main partner only 33 7.5
With casual partner(s) 70 23.3
Drug use behaviors
Ever injected drugs
No 403 91.4
Yes 38 8.6
Table 1 continued
N %
Noninjection drug use in last 12
months
No 219 49.7
Yes 222 50.3
Cocaine, heroin, or crack use in last
12 months (Noninjection)
No 225 50.7
Yes 219 49.3
IDU, heroin, cocaine, crack
speedball, meth in the last 12 months
No 432 97.3
Yes 12 2.7
Health history and insurance
Ever been tested for HIV 40 9.0
No 404 91.0
Yes
In past 12 months, tested for HIV
No 209 47.2
Yes 234 52.8
HIV test result
Negative 229 58.4
Previously diagnosed positive 50 12.8
Newly diagnosed positive 113 28.8
Current health insurance
No 123 28.0
Yes 316 72.0
Visit a doctor’s office in last 12
months
No 85 19.3
Yes 355 80.7

6. Table 2 Bivariate associations with smoking status among MSM
Non Current Former Chi p value Current smokers Former smokers
smokers smokers smokers square
N % N % N % Odds Ratio Odds ratio
(95% CI)b
(95% CI)b
Sociodemographic
Race 26.31 <0.001
White, not Hispanic a
12 18.8 28 43.8 24 37.5
Black, not Hispanic 90 26.4 215 63.1 36 10.6 1.02 (0.50–2.1) 0.20 (0.09–0.44)
Other 7 18.0 25 64.1 7 18.0 1.53 (0.52–4.49) 0.50 (0.14–1.76)
Age (years) 29.1 <0.001
18 – 24 a
53 35.8 76 51.4 19 12.8
25 – 34 22 19.3 69 60.5 23 20.2 2.19 (1.21–3.96) 2.92 (1.33–6.39)
35 – 44 16 21.1 53 69.7 7 9.2 2.31 (1.19–4.47) 1.22 (0.44–3.42)
45 – 54 11 13.6 60 74.1 10 12.4 3.8 (1.83–7.91) 2.54 (0.93–6.92)
55+ 7 28.0 10 40.0 8 32.0 0.97 (0.36–2.78) 3.19 (1.02–9.99)
Highest level of education
completed
37.85 <0.001
Less than grade 12 a
4 6.9 52 89.7 2 3.5
Grade 12 or GED 48 25.5 118 62.8 22 11.7 0.19 (0.06–0.55) 0.92 (0.16–5.39)
More than grade 12 57 28.9 97 49.2 43 21.8 0.13 (0.04–0.38) 1.51 (0.26–8.62)
Income 9.61 0.142
< $10,000 a
34 23.6 95 66.0 15 10.4
$10,000 - $19,999 19 21.4 59 66.3 11 12.4 1.11 (0.58–2.13) 1.31 (0.50–3.43)
$20,000 - $39,999 26 27.1 55 57.3 15 15.6 0.76 (0.41–1.39) 1.31 (0.54–3.15)
>$40,000 25 26.9 47 50.5 21 22.6 0.67 (0.36–1.26) 1.90 (0.82–4.41)
Currently Homeless 25.53 <0.001
No a
108 26.3 237 57.7 66 16.1
Yes 0 0.0 29 96.7 1 3.3
Ever Homeless 29.59 <0.001
No a
103 27.8 204 55.1 63 17.0
Yes 5 7.0 61 87.3 4 5.6 6.26 (2.44-16.05) 1.31 (0.34–5.05)
Ever held or arrested 50.33 <0.001
No a
87 35.1 115 46.4 46 18.6
Yes 22 24.6 153 78.1 21 10.7 5.26 (3.11–8.91) 1.81 (0.90–3.62)
Held or arrested in past 12
months
12.22 0.002
No a
103 26.8 221 57.4 61 15.8
Yes 6 10.2 47 79.7 6 10.2 3.65 (1.51–8.81) 1.69 (0.52–5.47)
Sexual behaviors
No. of male sex partners
in last 12 months
13.28 0.039
One a
35 28.9 72 59.5 14 11.6
2 to 3 45 27.1 102 61.5 19 11.5 1.10 (0.65–1.88) 1.06 (0.47–2.40)
4 to 8 17 15.5 70 63.6 23 20.9 2.00 (1.0 -3.90) 3.38 (1.40–8.17)
9 or more 12 25.2 24 15.1 11 23.4 0.97 (0.44–2.17) 2.29 (0.82–6.40)
In past 12 months, any
sex with
31.90 <0.001
Men onlya
97 28.6 181 53.4 61 18.0
Men and women 12 11.4 87 82.9 6 5.7 3.89 (2.02–7.46) 0.80 (0.28–2.23)
In past 12 months any
UAI with
7.46 0.113
No UAIa
87 25.6 207 60.9 46 13.5
Main partner only 11 33.3 15 45.5 7 21.2 0.57 (0.25–1.30) 1.20 (0.44–3.31)
With casual partner(s) 11 15.7 45 64.3 67 20.0 1.72 (0.85–3.48) 2.41 (1.01–5.73)
Drug use behaviors
Ever injected drugs 5.74 0.057
No a
103 25.6 238 59.1 62 15.4
Yes 4 10.5 29 76.3 5 13.2 3.14 (1.08–9.15) 2.08 (0.54–8.03)

7. Cocaine, heroin, or crack
use in last 12 months
(Noninjection)
34.36 <0.001
No a
78 34.7 107 47.6 40 17.8
Yes 31 14.2 161 73.5 27 12.3 3.79 (2.34–6.13) 1.70 (0.89–3.23)
IDU, heroin, cocaine,
crack speedball, meth in
the last 12 months
12.33 0.002
No a
109 25.2 256 59.3 67 15.5
Yes 0 0.0 12 60.4 67 15.1
Health history and
insurance
Ever been tested for HIV 0.21 0.900
No a
11 27.5 23 57.5 6 15.0
Yes 98 24.3 245 60.6 61 15.1 1.12 (0.56–2.55) 1.14 (0.40–3.24)
In past 12 months, tested
for HIV
3.13 0.209
No a
43 20.6 133 63.6 33 15.8
Yes 65 27.8 135 57.7 67 15.1 0.67 (0.43–1.06) 0.68 (0.37–1.26)
HIV test result 6.19 0.185
Negative a
54 23.6 133 58.1 42 18.3
Previously diagnosed
positive
10 20.0 32 64.0 8 16.0 1.30 (0.60–2.83) 1.03 (0.37–2.83)
Newly diagnosed
positive
29 25.7 74 65.5 10 8.8 1.04 (0.61–1.77) 0.44 (0.19–1.01)
Current health insurance 1.95 0.378
No a
25 20.3 80 65.0 18 14.6
Yes 83 26.3 185 58.5 48 15.2 0.70 (0.41–1.17) 0.80 (0.40–1.17)
Visit a doctor’s office in
last 12 months
5.36 0.069
No a
17 20.0 60 70.6 8 9.4
Yes 91 25.6 205 57.8 59 16.6 0.64 (0.35–1.15) 1.38 (0.56–3.40)
a
Denotes referent group
b
Odds ratio 95 % confidence intervals that do not contain 1.00 are presented in bold

8. Table 3 Multivariable analysis of smoking status among MSM
Current smokers Former smokers Wald Chi square p value
Adjusted odds ratio (95 % CI) Adjusted odds ratio (95 % CI)
Sociodemographic
Race 19.20 <0.001
White, not Hispanic a
Black, not Hispanic 0.60 (0.26-1.39) 0.14 (0.05–0.37)
Other 0.79 (0.23-2.72) 0.42 (0.10-1.66)
Age (years) 20.02 0.0103
18 – 24 a
25 – 34 2.26 (1.14-4.54) 2.55 (1.08-6.04)
35 – 44 1.53 (0.68-3.46) 0.77 (0.24-2.51)
45 – 54 4.01 (1.73-9.28) 1.64 (0.53-5.09)
55+ 0.89 (0.26-3.11) 1.47 (0.38-5.64)
Highest level of education completed 10.93 0.027
Less than grade 12 a
Grade 12 or GED 0.27 (0.08 – 0.85) 0.86 (0.13 – 5.45)
More than grade 12 0.20 (0.06 – 0.66) 1.03 (0.16 – 6.47)
Ever Homeless 6.73 0.035
No a
Yes 2.95 (1.03 – 8.49) 0.96 (0.23 – 4.09)
Ever held or arrested 13.89 0.001
No a
Yes 3.29 (1.74 – 6.20) 3.14 (1.35 – 7.33)
Sexual behaviors
No. of male sex partners in last 12
months
13.40 0.037
One a
2 to 3 0.86 (0.46 – 1.63) 1.00 (0.41 – 2.45)
4 to 8 2.20 (0.97 – 5.01) 3.76 (1.34 – 10.51)
9 or more 0.77 (0.25 – 2.33) 2.67 (0.73 – 9.77)
In past 12 months, any
sex with
31.90 0.289
Men onlya
Men and women 1.27 (0.58 – 2.77) 0.59 (0.13 – 5.45)
In past 12 months any UAI with 1.09 0.896
No UAIa
Main partner only 0.75 (0.28 – 1.97) 1.14 (0.35 – 3.65)
With casual partner(s) 1.17 (0.46 – 2.94) 1.43 (0.48 – 4.26)
Drug use behaviors
Ever injected drugs 0.41 0.813
No a
Yes 1.47 (0.44 – 4.95) 1.50 (0.34 – 6.62)
Cocaine, heroin, or crack use in last
12 months (non IDU)
10.25 0.0059
No a
Yes 2.46 (1.41 – 4.28) 1.72 (0.83 – 3.56)
a
Denotes referent group
b
Adjusted odds ratio 95 % confidence intervals that do not contain 1.00 are presented in bold

9. Table 4 Multivariable analysis of smoking status among MSM (including Persons Living With HIV)
Current smokers Former smokers Wald Chi square p value
Adjusted odds ratio (95 % CI) Adjusted odds ratio (95 % CI)
Sociodemographic
Race 13.73 0.008
White, not Hispanic a
Black, not Hispanic 0.79 (0.32 - 1.96) 0.19 (0.07 – 0.53)
Other 1.34 (.35 - 5.20) 0.66 (0.15 2.98)
Age (years) 14.42 0.071
18 – 24 a
25 – 34 1.85 (0.90 - 3.80) 2.02 (0.80 – 5.07)
35 – 44 1.44 (0.61 - 3.42) 0.75 (0.22 - 2.56)
45 – 54 3.50 (1.47 - 8.35) 1.21 (0.36 – 4.05)
55+ 1.26 (0.32 – 4.90) 1.58 (0.37 – 6.70)
Highest level of education completed 10.67 0.031
Less than grade 12 a
Grade 12 or GED 0.26 (0.08 – 0.86) 0.89 (0.14 – 5.71)
More than grade 12 0.21 (0.06 – 0.69) 1.14 (0.18 – 7.30)
Ever Homeless 6.27 0.043
No a
Yes 2.77 (0.95 – 8.04) 0.85 (0.19 – 3.69)
Ever held or arrested 11.37 0.003
No a
Yes 3.02 (1.57 – 5.80) 2.86 (1.18 – 6.91)
Sexual behaviors
No. of male sex partners in last 12
months
13.33 0.038
One a
2 to 3 0.80 (0.41 – 1.56) 0.91 (0.35 – 2.35)
4 to 8 2.15 (0.82 – 5.67) 4.60 (1.43 – 14.80)
9 or more 0.73 (0.23 – 2.36) 2.77 (0.70 – 10.95)
In past 12 months, any
sex with
2.43 0.300
Men onlya
Men and women 1.24 (0.56 – 2.74) 0.56 (0.18 – 1.80)
In past 12 months any UAI with 2.82 0.588
No UAIa
Main partner only 0.47 (0.16 – 1.39) 1.08 (0.32 – 3.64)
With casual partner(s) 1.03 (0.39 – 2.74) 1.10 (0.35 – 3.52)
Drug use behaviors
Ever injected drugs 0.80 0.670
No a
Yes 1.69 (0.44 – 6.52) 2.03 (0.41 – 10.15)
Cocaine, heroin, or crack use in last
12 months (non IDU)
6.77 0.034
No a
Yes 2.16 (1.19 – 3.93) 1.43 (0.66 – 3.14)
HIV Status 1.89 0.389
Negative
Positive 1.14 (0.63 – 2.04) 0.69 (0.31 – 1.53)
a
Denotes referent group
b
Adjusted odds ratio 95 % confidence intervals that do not contain 1.00 are presented in bold