Boston University School of Social Work, Boston, MA, USA.
The Fenway Institute, Fenway Health, Boston, MA, USA.
AIDS Care. 2023 Apr;35(4):614-623. doi: 10.1080/09540121.2022.2076801. Epub 2022 Jun 2.
HIV continues to be a critical health issue for sexual minority men (SMM) in the USA. Chronic pain is common in individuals with HIV, including older SMM, and is associated with substance use behaviors. This cross-sectional study sought to address a gap in the literature by characterizing interrelationships among chronic pain, substance use disorders (SUDs), medication adherence, and engagement in HIV care among older (≥50) SMM living with HIV and chronic pain (N = 63). The unadjusted relationship between an opioid use disorder and pain indicated that participants with an opioid use disorder reported higher pain ratings than those without. Presence of alcohol use disorder was significantly associated with missed HIV-care appointments due to chronic pain or substance use, showing that individuals with an alcohol use disorder reported more missed appointments in the past year. Higher pain was significantly associated with the same missed appointments variable, such that those reporting higher pain ratings also reported more missed appointments in the past year. These findings provide preliminary evidence of the interrelationships among chronic pain, SUDs, and engagement in HIV care among older SMM living with HIV and suggest that pain management in this population might support fuller engagement in HIV care.
艾滋病毒仍然是美国性少数群体男性（SMM）的一个重大健康问题。慢性疼痛在艾滋病毒感染者中很常见，包括老年 SMM，并且与物质使用行为有关。这项横断面研究试图通过描述艾滋病毒和慢性疼痛（N = 63）老年（≥50 岁）SMM 中慢性疼痛、物质使用障碍、药物依从性和参与艾滋病毒护理之间的相互关系来填补文献中的空白。阿片类药物使用障碍与疼痛之间的未调整关系表明，患有阿片类药物使用障碍的参与者报告的疼痛评分高于没有阿片类药物使用障碍的参与者。酒精使用障碍的存在与因慢性疼痛或物质使用而错过艾滋病毒护理预约显著相关，表明患有酒精使用障碍的个体在过去一年中报告了更多的错过预约。更高的疼痛与相同的错过预约变量显著相关，即报告更高疼痛评分的人在过去一年中也报告了更多的错过预约。这些发现提供了初步证据，表明艾滋病毒和慢性疼痛老年 SMM 中物质使用障碍和参与艾滋病毒护理之间的相互关系，并表明该人群的疼痛管理可能支持更充分地参与艾滋病毒护理。
