Risk factors for community-acquired pneumonia among persons infected with human immunodeficiency virus

Two hundred eleven adults with human immunodeficiency virus (HIV) infection hospitalized for community-acquired pneumonia, including Pneumocystis cari nii pneumonia (PCP; patients), and 192 matched HIV-infected hospitalized pa tients without pneumonia (controls) were interviewed to determine risk fact ors for pneumonia, Multivariate logistic regression showed that patients we re less likely than controls to have used trimethoprim-sulfamethoxazole (TM P-SMZ) prophylaxis (odds ratio [OR], 0.22; 95% confidence interval [CT], 0. 12-0.41) and more likely to have been hospitalized previously with pneumoni a (OR, 6.25; CI, 3.40-11.5). Patients were also more likely than controls t o have gardened (OR, 2.24; CI, 1.00-5.02) and to have camped or hiked (OR, 4.95; CI, 1.31-18.7), but stratified analysis by etiologic agent showed thi s association only for PCP. These findings reconfirm the efficacy of TMP-SM Z in preventing community-acquired pneumonia, In addition, hospitalization for pneumonia might represent a missed opportunity to encourage HIV-infecte d patients to enter into regular medical care and to adhere to prescribed a ntiretroviral and prophylaxis medications.