Edwards Karlyn A, Long Dustin, Jones Katie Fitzgerald, Durr Amy L, Farel Claire E, Liebschutz Jane M, Bair Matthew J, Agil Deana, Napravnik Sonia, Browne Lindsay, Johnson Bernadette, Thomas Tammi, Burkholder Greer, Clay Olivio J, Demonte William, Orris Sarah Margaret, Johnson Mallory O, Merlin Jessica
Division of General Internal Medicine University of Pittsburgh Pittsburgh, PA, USA.
Department of Biostatistics Wake Forest University Winston-Salem, NC, USA.
J Acquir Immune Defic Syndr. 2025 Jun 18. doi: 10.1097/QAI.0000000000003706.
People with HIV (PWH) commonly endorse chronic pain contributing to poor HIV outcomes. The current study is a secondary analysis of a multi-site randomized control trial that improved pain with a behavioral pain treatment, Skills to Manage Pain (STOMP), among PWH and chronic pain. We examined whether participants randomized to STOMP, as compared to enhanced usual care (EUC), evidenced improved HIV outcomes at 12-month follow-up visit.
Participants (N=278) were recruited from Center for AIDS Research Network of Integrated Clinical Systems clinics in Alabama and North Carolina. Eligible participants were randomized to receive either STOMP, combined 1-on-1 skill-building sessions delivered by staff interventionists with group sessions co-led by peer interventionists, or EUC.
We compared 12-month outcomes of adherence to anti-retroviral therapy (ART), retention in HIV care, virologic suppression. We employed logistic regressions using generalized estimating equations to account for correlations within groups and were adjusted for baseline values.
At baseline, most participants were virologically suppressed (STOMP: 95.2%; EUC: 93.6%) and adherent to ART (≥90% medication taken past month; STOMP: 93.6%, EUC: 89.0%). There were no significant differences between EUC and STOMP for adherence to ART, retention in HIV care, or virologic suppression at 12-month follow-up (all p's > .16).
Participants receiving STOMP had no differences in 12-month HIV outcomes, despite improvements in chronic pain severity at 3-months. High baseline adherence may have created a ceiling effect on changes.
感染艾滋病毒的人（PWH）普遍认可慢性疼痛会导致艾滋病毒感染情况不佳。本研究是一项多中心随机对照试验的二次分析，该试验采用行为疼痛治疗方法“疼痛管理技能（STOMP）”改善了PWH的慢性疼痛。我们研究了与强化常规护理（EUC）相比，随机分配到STOMP组的参与者在12个月随访时艾滋病毒感染情况是否有所改善。
参与者（N = 278）从阿拉巴马州和北卡罗来纳州的综合临床系统艾滋病研究网络诊所招募。符合条件的参与者被随机分配接受STOMP，即由工作人员干预者提供一对一技能培训课程，并由同伴干预者共同主持小组课程，或接受EUC。
我们比较了抗逆转录病毒疗法（ART）依从性、艾滋病毒护理留存率、病毒学抑制的12个月结果。我们使用广义估计方程进行逻辑回归，以考虑组内相关性，并对基线值进行了调整。
在基线时，大多数参与者病毒学得到抑制（STOMP组：95.2%；EUC组：93.6%）且坚持接受ART治疗（过去一个月服药率≥90%；STOMP组：93.6%，EUC组：89.0%）。在12个月随访时，EUC组和STOMP组在ART依从性、艾滋病毒护理留存率或病毒学抑制方面没有显著差异（所有p值>.16）。
接受STOMP治疗的参与者在12个月的艾滋病毒感染情况上没有差异，尽管在3个月时慢性疼痛严重程度有所改善。较高的基线依从性可能对变化产生了上限效应。
