Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Oct 1;61(2):164-70.
doi: 10.1097/QAI.0b013e3182662215.

Pain, mood, and substance abuse in HIV: implications for clinic visit utilization, antiretroviral therapy adherence, and virologic failure

Jessica S Merlin  1 , Andrew O Westfall, James L Raper, Anne Zinski, Wynne E Norton, James H Willig, Robert Gross, Christine S Ritchie, Michael S Saag, Michael J Mugavero
Affiliations

Pain, mood, and substance abuse in HIV: implications for clinic visit utilization, antiretroviral therapy adherence, and virologic failure

Jessica S Merlin et al. J Acquir Immune Defic Syndr. .

Erratum in

  • J Acquir Immune Defic Syndr. 2013 May 1;63(1):e38-9

Abstract

Background: Cooccurring 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 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 1-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 those without these conditions [odds ratio (OR), 1.4; 95% confidence interval (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.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

For the remaining authors none were declared.

References

    1. Merlin JS, Cen L, Praestgaard A, et al. Pain and Physical and Psychological Symptoms in Ambulatory HIV Patients in the Current Treatment Era. J Pain Symptom Manage. 2011 Nov 22; [Epub ahead of print] - PMC - PubMed
    1. Newshan G, Bennett J, Holman S. Pain and other symptoms in ambulatory HIV patients in the age of highly active antiretroviral therapy. J Assoc Nurses AIDS Care. 2002;13(4):78–83. - PubMed
    1. Harding R, Molloy T, Easterbrook T, et al. Is antiretroviral therapy associated with symptom prevalence and burden? Int J STD AIDS. 2006;17:400–5. - PubMed
    1. Silverberg MJ, Gore ME, French AL, et al. Prevalence of clinical symptoms associated with Highly Active Antiretroviral Therapy in the Women’s Interagency HIV Study. Clin Infect Dis. 2004;39:717–24. - PMC - PubMed
    1. Cervia LD, McGowan JP, Weseley AJ. Clinical and demographic variables related to pain in HIV-infected individuals treated with effective, combination antiretroviral therapy (cART) Pain Med. 2010;11(4):498–503. - PubMed

Publication types

Substances