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It’s well established that smoking can cause an early death, and HIV can too. But combine the two, and the deadly punch is much more powerful.

In fact, in a Danish study in which patients got top-of-the-line HIV care including free antiretroviral medication, HIV-positive smokers lost more years of life from smoking than from HIV.
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People with HIV are often part of demographic groups that have especially high rates of smoking, namely gay men and African-Americans.

People with HIV in the U.S. also tend to have less formal education and to come from poorer family backgrounds, Brooks said. They may also have issues related to substance abuse or mental illness. These factors are also linked to higher rates of smoking.
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In the study, a person with HIV lost five years of life to the disease. A smoker without HIV lost almost four years of life to smoking. But a person with HIV who also smoked lost a total of 12 years of life, not nine, as one might think.

"If a person's HIV is under control, the risk of smoking remains and becomes a greater and often leading preventable risk for illness and death," Brooks said.
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