Ferguson Erin, Pantalone David W, Monti Peter M, Mayer Kenneth H, Kahler Christopher W
Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 S Main St, Providence, RI, 02903, USA.
University of Massachusetts Boston, Boston, MA, USA.
AIDS Behav. 2025 Jun;29(6):1841-1850. doi: 10.1007/s10461-025-04652-8. Epub 2025 Feb 10.
Unhealthy alcohol use is prevalent among people with HIV, particularly among men who have sex with men (MSM). Pain frequently co-occurs with unhealthy alcohol use and is associated with suboptimal HIV care outcomes. The present study examined the effects of pain severity and experiences with pain management care (i.e., satisfied, dissatisfied, managing pain on own) on alcohol use. Participants were MSM with HIV reporting heavy alcohol use and pain in the past 30 days who were enrolled in a clinical trial targeting alcohol use (N = 125, 78.4% White, M=41.2). Participants completed measures of unhealthy alcohol use [alcohol-related problems, heavy drinking days, drinks per week, drinking to manage pain (yes/no)], pain severity, and pain management care experiences. An analysis of variance examined differences in pain severity by pain management experience. Regression analyses examined the associations of pain severity and pain management experience with unhealthy alcohol use. Pain severity was significantly associated with drinking to manage pain and heavy drinking days, but not drinks per week or alcohol-related problems. MSM with HIV who were dissatisfied with pain care reported significantly greater pain severity compared to those who were satisfied or managing pain on their own. Compared to satisfaction, dissatisfaction with pain care was also associated with significantly higher odds of drinking to manage pain, although the inclusion of pain severity attenuated this association. Results highlight pain severity as a key factor related to pain management experience and unhealthy alcohol use among MSM with HIV. Future studies should prioritize pain-alcohol integrated intervention development.
不健康饮酒在艾滋病毒感染者中很普遍，尤其是在男男性行为者（MSM）中。疼痛经常与不健康饮酒同时出现，并与不理想的艾滋病毒护理结果相关。本研究考察了疼痛严重程度和疼痛管理护理经历（即满意、不满意、自行管理疼痛）对饮酒的影响。参与者是在过去30天内报告有大量饮酒和疼痛的感染艾滋病毒的男男性行为者，他们参加了一项针对饮酒的临床试验（N = 125，78.4%为白人，平均年龄41.2岁）。参与者完成了不健康饮酒的测量指标[与酒精相关的问题、重度饮酒天数、每周饮酒量、为缓解疼痛而饮酒（是/否）]、疼痛严重程度以及疼痛管理护理经历。方差分析考察了不同疼痛管理经历下疼痛严重程度的差异。回归分析考察了疼痛严重程度和疼痛管理经历与不健康饮酒之间的关联。疼痛严重程度与为缓解疼痛而饮酒以及重度饮酒天数显著相关，但与每周饮酒量或与酒精相关的问题无关。与对疼痛护理满意或自行管理疼痛的艾滋病毒感染者相比，对疼痛护理不满意的男男性行为者报告的疼痛严重程度明显更高。与满意相比，对疼痛护理不满意还与为缓解疼痛而饮酒的几率显著更高有关，不过纳入疼痛严重程度后减弱了这种关联。结果突出了疼痛严重程度是与感染艾滋病毒的男男性行为者的疼痛管理经历和不健康饮酒相关的关键因素。未来的研究应优先开发疼痛 - 酒精综合干预措施。
