Background:
Smoking is one of the major preventable causes of disease and premature death globally. Emerging findings have highlighted the intersection of cigarette smoking and HIV/AIDS as a significant public health concern. For adults with HIV, smoking increases both HIV-related and non-related outcomes. There is scarcity of information on the incidence and effects of cigarette smoking as well as its management in the HIV-infected population in South Africa. This study therefore aimed to determine the occurrence of smoking in HIV positive patients attending public healthcare facilities in the Western Cape Province of South Africa.

Methods:
An overall of 751 patients living with HIV randomly selected and screened from 17 different HIV/AIDS public facilities in the Western Cape at both primary and secondary level were included for this study between 2014 and 2015. This article focuses on the self-reported tobacco-using behavior of adults aged >18 years. The survey instrument included questions on the respondents´ history of smoking tobacco, current use of other tobacco products, frequency and duration of use, and attempts to stop smoking tobacco or using other tobacco products.

Results:
Of the 751 HIV positive patients receiving medical care at public healthcare facilities, an overall of 20.7% (95% CI, 17.3% to 24.1%) were current smokers, 14.5% (CI, 11.6% to 17.4%) were former smokers, while 65.3% (CI, 54.6% to 68.9%) had never smoked. Out of these the current smokers, 18.9% (95% CI, 12.3% to 25.5%) were men while 20.8% (95% CI, 16.9% to 24.7%) were women. Among the patients living with HIV, factors independently associated with greater smoking prevalence were gender, age, unemployment, household smoking, and excessive alcohol use.

Conclusions:
We found a high prevalence of hypertension among patients receiving routine care for HIV infection across public HIV clinics in this setting.