Pain and alcohol consumption among people living with HIV: examining the moderating roles of depression and social support

Pain and heavy alcohol use are common among people living with HIV (PLWH), and influence one another, potentially exacerbating these conditions over time. This study examines the prospective association between pain and alcohol use among PLWH with a history of unhealthy drinking behaviors and/or substance use and tests whether depression and social support are moderators. A sample of 233 participants from the Boston Alcohol Research Collaborative on HIV/AIDS cohort completed measures of pain intensity (i.e., average severity of pain in the past week) and pain interference (i.e., average interference of pain in everyday life), heavy episodic drinking, number of drinks, social support and depression at baseline and 6 months later. Negative binomial regression analyses assessed whether pain at baseline predicted alcohol use at 6 months, and examined baseline social support and depression as moderators. Pain intensity was significantly associated with number of drinks (IRR = 1.80, 95 % CI: 1.05, 3.08) but not number of heavy drinking days (IRR = 1.84, 95 % CI: 0.83, 4.07), while pain interference was not associated with number of drinks (IRR = 1.63, 95 % CI: 0.96, 2.75) nor heavy drinking days (IRR = 1.43, 95 % CI: 0.64, 3.17) at six months. Neither social support, nor depression were significant moderators of the association between pain and 6-month alcohol use outcomes. Pain intensity is prospectively associated with more alcohol use, but not with heavy drinking among PLWH. We conclude that pain is an important factor to address when considering interventions to reduce alcohol use among PLWH.