Pain and unhealthy alcohol use among people living with HIV: A prospective cohort study.

IF 3 Q2 SUBSTANCE ABUSE
Alcohol (Hanover, York County, Pa.) Pub Date : 2024-11-01 Epub Date: 2024-09-24 DOI:10.1111/acer.15447
Tibor P Palfai, Michael R Winter, Kara M Magane, Timothy C Heeren, Lauren B Bernier, Grace E Murray, Richard Saitz, Theresa W Kim, Michael D Stein
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Abstract

Background: Unhealthy alcohol use is prevalent among people living with HIV/AIDS (PLWH) and contributes to impaired functioning, diminished quality of life, and poorer HIV outcomes. Common cooccurring conditions such as chronic pain may be associated with negative outcomes both directly and through its influence on unhealthy drinking itself. However, there is relatively little known about how pain influences unhealthy drinking among PLWH over time. The current study examined whether pain was associated with indices of unhealthy alcohol use, namely heavy drinking and alcohol use disorder (AUD) assessed 12 months later.

Methods: The study sample (n = 207) was from the Boston Alcohol Research Collaboration on HIV/AIDS (ARCH) Cohort, a prospective cohort of PLWH with a history of illicit substance or unhealthy alcohol use. We conducted logistic regression analyses to examine the associations between pain and both heavy drinking and AUD status (DSM-5 criteria) (yes/no) over time. In secondary analyses, we examined whether pain was associated with greater AUD severity and whether pain interference was associated with heavy drinking and AUD outcomes.

Results: We found that pain at baseline was associated with greater odds of AUD [aOR = 2.29 (95% CI: 1.13, 4.64), p = 0.02] but not heavy drinking [aOR = 0.91 (95% CI: 0.44, 1.88), p = 0.79] at 12 months. Pain was also associated with more severe AUD. Analyses of pain interference showed similar results.

Conclusions: Pain is prospectively associated with higher odds of AUD among PLWH with a substance/unhealthy alcohol use history. Providers should routinely address pain among PLWH to improve AUD outcomes.

艾滋病病毒感染者的疼痛与不健康饮酒:前瞻性队列研究。
背景:不健康饮酒在艾滋病病毒感染者/艾滋病患者(PLWH)中十分普遍,会导致功能受损、生活质量下降和艾滋病治疗效果不佳。慢性疼痛等常见并发症可能直接或通过其对不健康饮酒本身的影响而与不良后果相关。然而,人们对疼痛如何长期影响 PLWH 不健康饮酒的了解相对较少。本研究探讨了疼痛是否与不健康饮酒指数相关,即 12 个月后评估的大量饮酒和酒精使用障碍(AUD):研究样本(n = 207)来自波士顿艾滋病毒/艾滋病酒精研究合作组织(ARCH)队列,该组织是一个前瞻性队列,对象是有非法药物或不健康饮酒史的 PLWH。我们进行了逻辑回归分析,以研究疼痛与长期大量饮酒和 AUD 状态(DSM-5 标准)(是/否)之间的关系。在二次分析中,我们研究了疼痛是否与更严重的 AUD 相关,以及疼痛干扰是否与大量饮酒和 AUD 结果相关:我们发现,基线疼痛与 12 个月时更大的 AUD 相关[aOR = 2.29 (95% CI: 1.13, 4.64),p = 0.02],但与大量饮酒无关[aOR = 0.91 (95% CI: 0.44, 1.88),p = 0.79]。疼痛也与更严重的 AUD 有关。对疼痛干扰的分析表明了类似的结果:结论:在有药物/不健康饮酒史的 PLWH 中,疼痛与更高的 AUD 相关。医疗服务提供者应定期处理 PLWH 中的疼痛问题,以改善 AUD 的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
5.40
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