Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.
Pain Med. 2021 Mar 18;22(3):577-584. doi: 10.1093/pm/pnaa351.
The transition of HIV from an acute, fatal illness to a chronic health condition has shifted the treatment needs of people living with HIV (PLWH). PLWH, including sexual minority men (SMM), are living longer and are subject to health concerns often associated with aging. A major health concern of older SMM living with HIV who report problematic substance use is chronic pain. This qualitative analysis of 15 one-on-one interviews with older SMM living with HIV and chronic pain aimed to characterize this population's experiences with pain, engagement in HIV care, and problematic substance use. This study was conducted in a community health center in Boston, MA. We also solicited suggestions for preferred intervention strategies.
Three main themes emerged from the interview transcripts: 1) the impact of chronic pain and pain treatment on engagement in HIV clinical care; 2) the impact of substance use on chronic pain; and 3) response to interventions to address chronic pain and substance use.
These findings underscore the need for interventions that address the structural, physical, and psychological barriers to engagement in medical and self-care that affect older SMM living with HIV and chronic pain.
HIV 从急性、致命疾病向慢性健康状况的转变，改变了 HIV 感染者（PLWH）的治疗需求。包括性少数群体男性（SMM）在内的 PLWH 活得更长，他们面临着与衰老相关的健康问题。对于报告有问题的物质使用的老年 SMM 来说，一个主要的健康问题是慢性疼痛。这项对 15 名患有 HIV 和慢性疼痛的老年 SMM 进行的一对一访谈的定性分析旨在描述该人群的疼痛体验、参与 HIV 护理和有问题的物质使用情况。这项研究在马萨诸塞州波士顿的一家社区医疗中心进行。我们还征求了对首选干预策略的建议。
访谈记录中出现了三个主要主题：1）慢性疼痛和疼痛治疗对参与 HIV 临床护理的影响；2）物质使用对慢性疼痛的影响；3）应对干预措施以解决慢性疼痛和物质使用问题的反应。
这些发现强调了需要采取干预措施，解决影响患有 HIV 和慢性疼痛的老年 SMM 参与医疗和自我保健的结构性、身体和心理障碍。
