Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, 21205, MD, USA.
AIDS Behav. 2018 Jun;22(6):2002-2007. doi: 10.1007/s10461-017-1775-9.
Among persons living with HIV/AIDS (PLHIV), approximately two-thirds report moderate to severe pain. Chronic pain can negatively affect PLHIVs' health behaviors and outcomes by interfering with their reciprocity (mutual exchange) of support in their caregiving relationships, which has been found to be associated with PLHIVs' antiretroviral adherence and viral suppression. Data were longitudinal (baseline, 6- and 12-month follow-up) from 383 PLHIV who were formerly or currently using drugs. Utilizing a longitudinal lagged fixed effects structural equation model, we found that never having pain in the past 6 months was predictive of increased reciprocity of support. Sub-analyses by care relationship type revealed never having pain was a significant predictor of greater reciprocity for sexual partner caregiving dyads, but not for kin or friend caregiving dyads. Our study emphasizes the importance of pain management in quality caregiving relationships characterized by reciprocity, which has consistently been found to be associated with stronger, more supportive caregiving relationships and better quality of life. Our findings suggest the importance of pain management intervention for improving reciprocity between vulnerable PLHIVs and their primary caregivers, especially between PLHIVs and caregivers who are current or former sexual partners.
在感染艾滋病毒/艾滋病的人群（PLHIV）中，约有三分之二的人报告有中度至重度疼痛。慢性疼痛会通过干扰他们在护理关系中的相互支持（相互交换），对 PLHIV 的健康行为和结果产生负面影响，而这种相互支持已被发现与 PLHIV 的抗逆转录病毒药物依从性和病毒抑制有关。这些数据来自 383 名曾经或正在使用毒品的 PLHIV，是纵向的（基线、6 个月和 12 个月随访）。利用纵向滞后固定效应结构方程模型，我们发现过去 6 个月内从未有过疼痛与增加支持的相互性有关。通过护理关系类型的亚分析发现，过去 6 个月内从未有过疼痛是性伴侣护理关系中相互支持更大的显著预测因素，但对亲属或朋友护理关系则不然。我们的研究强调了在以相互性为特征的优质护理关系中进行疼痛管理的重要性，因为相互性一直与更强、更支持性的护理关系和更好的生活质量有关。我们的研究结果表明，疼痛管理干预对于改善脆弱的 PLHIV 与其主要照顾者之间的相互性，尤其是改善 PLHIV 与其当前或前任性伴侣之间的相互性，具有重要意义。
