INTRODUCTION: People with HIV (PWH) cite smoking within their social networks as a barrier to quitting. We examined the feasibility, acceptability, and preliminary efficacy of a tailored intervention, Peer Navigation Social Support for Smoking Cessation (PNSS-S), designed specifically for PWH who smoke. AIMS AND METHODS: We randomized 64 PWH who smoked (mean age 54.5 years
41% female) to PNSS-S or standard care (SC). After meeting with a clinic nurse to discuss quitting strategies and pharmacotherapy, the PNSS-S group received 12 weekly phone calls from a trained HIV peer navigator (PN), who provided smoking cessation counseling and social support for quitting. Outcomes were assessed at 12 and 24 weeks. RESULTS: Sixty-two percent of participants indicated interest in quitting at baseline. PN utilization was high with a mean number of weekly calls completed of 8.9 (SD 3.1), demonstrating excellent feasibility. Higher treatment satisfaction scores (29.1 [SD 3.0]) were reported in PNSS-S, compared to control (25.8 [SD 4.1], t = -3.39, d = 0.89, p = .001). Notably, positive social support for quitting increased significantly from baseline to week 12 in PNSS-S (17.4 [SD 11.4] to 25.1 [SD 12.2], p = .01), whereas SC showed no significant change (t = 1.11, df 29, p = .24). At week 24, 5 (16.6%) participants in PNSS-S and 3 (8.8%) in SC endorsed 7-day point-prevalence smoking abstinence: OR = 2.05 95% CI = [0.45 to 10.88]. CONCLUSIONS: Peer-based smoking cessation counseling increased the odds of abstinence and significantly increased social support for quitting. Further study is warranted. IMPLICATIONS: Cross-training HIV PNs to address smoking cessation may be a cost-effective approach, as it utilizes existing HIV clinic-based resources. By strengthening social support and providing a peer-based approach, this intervention may help reduce the burden of tobacco-related health issues in this population, ultimately contributing to better overall health and longevity for PWH. Further research is needed to refine and expand upon these findings. CLINICAL TRIAL REGISTRATION: Clinical trials.gov registration number: NCT04327921.