Surratt Hilary L, Kurtz Steven P, Levi-Minzi Maria A, Cicero Theodore J, Tsuyuki Kiyomi, O'Grady Catherine L
1 Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University , Miami, Florida.
AIDS Patient Care STDS. 2015 Apr;29(4):186-92. doi: 10.1089/apc.2014.0104. Epub 2014 Jul 1.
Pain represents a significant source of morbidity, function loss, and decreased quality of life among people living with HIV. The present study examined the associations among pain, pain treatment, and ARV adherence among indigent, HIV-positive substance abusers. Participants were recruited via targeted sampling strategies, and completed a one-time computer-assisted personal interview. ANOVA and chi-square tests were used to analyze differences in demographics, health and psychological status, health behaviors, by pain and pain treatment status; a multivariate logistic regression model was constructed to examine the contribution of pain/treatment status to recent ARV adherence. Results indicated that those with untreated pain had lower odds of achieving gold-standard 95% ARV adherence as compared to the pain-free and treated pain groups; higher substance dependence symptoms were also associated with significantly lower odds of 95% ARV adherence. Findings suggest that pain management is critical to the health of people living with HIV, specifically those with high levels of co-morbid health and psychological problems. The prevalence of untreated pain was elevated among this group, and contributed to reduced ARV adherence. Providers of clinical care to disadvantaged HIV-positive patients should emphasize routine assessment and appropriate treatment of pain in order to provide comprehensive HIV care.
疼痛是艾滋病毒感染者发病、功能丧失和生活质量下降的一个重要原因。本研究调查了贫困的艾滋病毒阳性药物滥用者的疼痛、疼痛治疗与抗逆转录病毒治疗依从性之间的关联。通过针对性抽样策略招募参与者，并完成一次计算机辅助个人访谈。方差分析和卡方检验用于分析按疼痛和疼痛治疗状况划分的人口统计学、健康和心理状况、健康行为方面的差异；构建多元逻辑回归模型以检验疼痛/治疗状况对近期抗逆转录病毒治疗依从性的影响。结果表明，与无疼痛组和疼痛已治疗组相比，未治疗疼痛者达到抗逆转录病毒治疗95%金标准依从性的几率较低；较高的物质依赖症状也与95%抗逆转录病毒治疗依从性的显著较低几率相关。研究结果表明，疼痛管理对艾滋病毒感染者的健康至关重要，特别是那些患有多种合并健康和心理问题的人。该组中未治疗疼痛的患病率较高，并导致抗逆转录病毒治疗依从性降低。为弱势艾滋病毒阳性患者提供临床护理的人员应强调对疼痛进行常规评估和适当治疗，以便提供全面的艾滋病毒护理。
