It is well established that LGBT people have higher rates of smoking/ tobacco usage than heterosexuals. It is also known that gay and bisexual men and transgender people have higher rates of HIV than their heterosexual counterparts. It has been found that 85% of people with HIV have a history of lifetime tobacco usage. I could not find research that stated the number of HIV positive GBT people who smoke (and if you find it please leave it in the comments section!) one can probably extrapolate that smoking rates among GBT HIV positive people is considerable.
Cancer risk is increased by HIV, and there are several types of cancer that affect HIV positive individuals, including lung cancer, and several others. HIV+ smokers are more likely to develop Pneumocystis carinii, a type of pneumonia that is of specific concern to HIV positive people, while Mycobacterium avium complex, a life threatenting bacteria which affects around 40% of HIV+ people was found in Tobacco. The host of other health related problems that smoking causes (hypertension, COPD, etc) surely do a compromised immune system no favors.
While stigma stress certainly makes quitting smoking difficult, finding ways to combat smoking among HIV positive GBT people is clearly a much needed area in which there is work to be done. We must advocate for more research and evidence based interventions to be done in the area of smoking and tobacco cessation for GBT people living with HIV.