Skip Ribbon Commands
Skip to main content

Title

Pain, Mood, and Substance Abuse in HIV: Implications for Clinic Visit Utilization, ART Adherence, and Virologic Failure

Authors

JS Merlin, AO Westfall, JL Raper, et al.

Network Affiliation

Other

Organization

 

Journal Name

JAIDS

Publication Date

7/3/2012

PubMed Search

http://www.ncbi.nlm.nih.gov/pubmed/22766967

Link to full-text

 

PMID

 

Abstract

INTRODUCTION:

Co-occurring pain, mood disorders, and substance abuse are common in HIV-infected patients. Our objective was to investigate the relationship between pain, alone and in the context of mood disorders and substance abuse, on clinic utilization, antiretroviral therapy (ART) adherence, and virologic suppression.

METHODS:

Pain, mood disorders, and substance abuse were assessed at the first visit. No-show and urgent visits were measured over a one-year period. Models were adjusted for age, race, sex, insurance status, CD4+ T-lymphocyte count, and HIV risk factor.

RESULTS:

Among 1521 participants, 509 (34%) reported pain, 239 (16%) had pain alone, 189 (13%) had pain and a mood disorder, and 30 (2%) had pain and substance abuse. In univariate models, participants with pain, mood disorders, and substance abuse had higher odds of a no-show visit than participants without these conditions [OR 1.4 (95%CI 1.1-1.8); OR 1.5 (95% CI 1.2-1.9); OR 2.0 (95% CI 1.4-2.8), respectively]. In the multivariable model, pain increased the odds of a no-show visit only in participants without substance abuse [OR 1.5 (95%CI 1.1-1.9)], and pain reduced the odds of a no-show visit in participants with substance abuse [OR 0.5 (95% CI 0.2-0.9), p for interaction=0.0022].

CONCLUSIONS:

In this study, pain increased the odds of no-show visits, but only for participants without substance abuse. Because pain, mood disorders, and substance abuse are highly prevalent in HIV-infected patients, our findings have implications for HIV treatment success. Interventions that incorporate pain management may be important for improving health outcomes in patients living with HIV infection.

Keywords

 

Topic

Adherence; Behavior; Intervention; Substance Abuse

Attachments

Created at 7/13/2012 10:43 AM by Davis, Gregory P
Last modified at 7/13/2012 10:43 AM by Davis, Gregory P