Abstract Introduction: People living with HIV (PLWH) are at greater risk of developing conditions related to tobacco smoking, given their increased use of tobacco products. A higher prevalence of electronic cigarette use among PLWH than the general population has been also reported. This study assessed factors associated with tobacco smoking and electronic cigarette use among a Hispanic sample of PLWH in Puerto Rico (PR), Mexico, and San Francisco (SF). Methods: Data from an ongoing cross-sectional study (May 2023 – May 2024) of oral HPV infection among a sample of PLWH ≥21 years old in PR [n=211 (women: 26%, men: 74%)], Mexico [n=30 (women: 90%, men: 10%)], and SF [n=18 (women: 11%, men: 89%)] was analyzed. Eligibility criteria included being a participant in the CAMPO study (NCI#U54CA242646). People who agree to participate in the oral HPV study complete an interview that collects sociodemographic and clinical characteristics, and relevant clinical procedures. Chi-squared test, Fisher exact test, and logistic regression models were used to evaluate factors associated with current smoking and electronic cigarette use. Results: Mean age (years) was 51.0±12.7 SD in PR, 37.2±8.8 SD in Mexico, and 61.2±10.4 SD in SF. History of AIDS diagnosis was 18.1% in PR, 13.3% in Mexico and 37.5% in SF. In PR, 24.2% were current smokers, 8.6% were current users of electronic cigarettes, and 2.8% used both. In Mexico, 33.3% were current smokers, 3.3% were current users of electronic cigarettes, and 3.3% used both. In SF, 16.7% were current smokers, 22.2% were current users of electronic cigarettes, and 5.6% used both. Regarding other behavioral characteristics, 53.1% in PR, 26.7% in Mexico, and 44.4% in SF reported current alcohol intake and 19.0% in PR, 6.7% in Mexico, and 33.3% in SF reported current marihuana use. In PR, Mexico, and SF, the prevalence of lifetime non-injected drug use was 52.9%, 30.0%, and 66.7%, respectively, while the prevalence of injected drug use was 10.4%, 0.0%, and 16.7%, respectively. In the multivariable logistic regression model adjusted for tobacco consumption, persons with history of injection drug use (OR=1.23; 95% CI 1.04-1.50), and non-injection drug use (OR=1.14; 95% CI 1.03-1.27) had higher odds to be current smokers than their counterparts. Meanwhile, people who report current marihuana use had higher odds of electronic cigarettes use (OR=1.14, 95% CI: 1.04-1.26) in comparison to their counterparts. No significant differences were observed by sex-at-birth, age, and site of recruitment. Conclusion: Our results showed a high prevalence of tobacco consumption among Hispanics living with HIV in PR, Mexico, and San Francisco. Higher odds of tobacco consumption were observed among people with a history of drug use. Similarly, higher odds of electronic cigarette use were observed among people who reported marijuana consumption. These results highlight the need for smoking cessation interventions among high-risk population, such as PLWH with a history of drug use. Acknowledgment: NIDCR Grant #R56DE032668-01, NCI Grant #U54CA242646. Citation Format: Sandra I. Garcia-Camacho, Jeslie M. Ramos-Cartagena, Josue Perez-Santiago, Frances E. Vazquez-Sanchez, Michael A. Santiago-Marrero, Jorge Salmeron, Joel Palefsky, Ana P. Ortiz. Factors associated to tobacco smoking and electronic cigarette use among a Hispanic sample of persons living with HIV in Puerto Rico, Mexico, and San Francisco [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A013.