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Opioid Analgesic Misuse is Associated with Incomplete Antiretroviral Adherence in a Cohort of HIV-Infected Indigent Adults in San Francisco

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Abstract

There is little or no data examining the association between either pain or the use or misuse of opioid analgesic with adherence to antiretroviral medications (ARVs) among HIV-infected adults. We interviewed a community-based cohort of HIV-infected indigent adults prescribed antiretroviral medications (ARVs) quarterly to examine the association between (1) pain, (2) receipt of opioid analgesics, and (3) opioid analgesic misuse with self-reported ARV adherence. Of 281 participants, most (82.5 %) reported severe or moderate pain, half (52.4 %) received a prescription for opioids, and one quarter (24.6 %) misused opioid analgesics. Most (71.9 %) reported >90 % ARV adherence. In a GEE model, neither pain (unadjusted OR 1.14, CI 0.90–1.45) nor prescription of opioid analgesics (unadjusted OR 1.11, CI 0.84–1.49) were significantly associated with ARV adherence. Misuse of opioid analgesics was associated with incomplete adherence (AOR 1.42, CI 1.09–1.86). Individuals who misuse opioid analgesics, like those who use illicit substances, may have difficulty adhering to medication regimens.

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Acknowledgments

This study was funded by a grant from the National Institute of Drug Abuse R01DA022550, and a grant from the National Institute of Mental Health R01MH54907. This publication was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number UL1 RR024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The funders had no role in the design or conduct of the study or the preparation of the manuscript. Drs. Kushel and Jeevanjee had full access to the data and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Division of Hospital Medicine, University of California San Francisco/San Francisco General Hospital, San Francisco, CA, USA

    Sara Jeevanjee

  2. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA

    Joanne Penko

  3. Division of General Internal Medicine, University of California, San Francisco/San Francisco General Hospital, Box 1364, San Francisco, CA, 94143-1364, USA

    David Guzman & Margot B. Kushel

  4. Department of Physiological Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, USA

    Christine Miaskowski

  5. Department of Global Health and Social Medicine, Massachusetts General Hospital, Ragon Institute of MGH, MIT, MGH Center for Global Health, Harvard Medical School, Harvard Initiative for Global Health, Boston, MA, USA

    David R. Bangsberg

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  1. Sara Jeevanjee
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  2. Joanne Penko
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  3. David Guzman
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  4. Christine Miaskowski
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  5. David R. Bangsberg
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  6. Margot B. Kushel
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Correspondence to Margot B. Kushel.

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Jeevanjee, S., Penko, J., Guzman, D. et al. Opioid Analgesic Misuse is Associated with Incomplete Antiretroviral Adherence in a Cohort of HIV-Infected Indigent Adults in San Francisco. AIDS Behav 18, 1352–1358 (2014). https://doi.org/10.1007/s10461-013-0619-5

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