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Frequent Occurrence of Pain and Prescription Opioid Use for Treatment of Pain Among Women with and at Risk for HIV Infection

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Abstract

Pain is frequent and underreported among HIV+ women. We determined occurrence and severity of pain, and types of pain treatments used among HIV+ and HIV− women. Cross-sectional analyses of pain as measured by the Brief Pain Inventory Short Form, and related pain therapies nested in the Women’s Interagency HIV Study (WIHS). Multiple variable linear regression models examined differences by HIV status in pain severity and pain interference in general activity, mood, ability to walk, work, relationships with others, sleep, and enjoyment of life. Among 1393 HIV+ and 587 HIV− participants with median age 47–48 years, there was no statistically significant difference in pain reported within the past week by HIV status (HIV+ 50% vs. 49% HIV−, p = 0.70). Ratings of pain severity and interference were similar between HIV+ and HIV− women, as was receipt of pain medication (58% HIV+ vs. 56% HIV−). Pain medications most frequently used were: NSAIDS (90% HIV+, 96% HIV−), opioids (65% HIV+, 67% HIV−), topical anesthetics (46% HIV+, 56% HIV−), muscle relaxants (23% HIV+, 14% HIV−), and anticonvulsants (23% HIV+, 14% HIV−). Nearly half of predominantly low income, minority women reported pain in the past week, and two-thirds reported opioid use for pain management. The occurrence, severity, and treatment of pain did not differ by HIV status, nor did report of pain interference with mood or function. Additional research is needed to better characterize pain etiology among HIV+ women in the era of potent antiretroviral therapy, and determine the extent to which pain severity and type of medication used for pain treatment impact HIV disease outcomes.

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Funding

The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA). WIHS (Principal Investigators): UAB-MS WIHS (Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kassaye), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women’s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Alexandra Levine and Marek Nowicki), U01-HD-032632 (WIHS I – WIHS IV). This research was also supported by National Institutes of Health K23AR06199301 (AS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH).

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Authors and Affiliations

  1. Department of Medicine, Albert Einstein College of Medicine, 1300 Morris Park Ave, Block Building #305, Bronx, NY, 10461, USA

    Anjali Sharma

  2. Department of Statistics, Rutgers University, Piscataway, NJ, USA

    Donald R. Hoover

  3. Department of Epidemiology and Community Health, New York Medical College, Valhalla, NY, USA

    Qiuhu Shi

  4. Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Jennie C. I. Tsao

  5. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Christopher Cox

  6. Department of Neurology, State University of New York Downstate Medical Center, Brooklyn, NY, USA

    Deborah R. Gustafson

  7. Department of Medicine, John H. Stroger Jr. Hospital of Cook County/Hektoen Institute of Medicine, Chicago, IL, USA

    Kathleen Weber

  8. Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, San Francisco, CA, USA

    Ruth M. Greenblatt

  9. Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, NY, USA

    Bradley E. Aouizerat

  10. Department of Medicine, Georgetown University Medical Center, Washington, DC, USA

    Michael W. Plankey

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  1. Anjali Sharma
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  2. Donald R. Hoover
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  3. Qiuhu Shi
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  4. Jennie C. I. Tsao
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  9. Bradley E. Aouizerat
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  10. Michael W. Plankey
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Correspondence to Anjali Sharma.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Sharma, A., Hoover, D.R., Shi, Q. et al. Frequent Occurrence of Pain and Prescription Opioid Use for Treatment of Pain Among Women with and at Risk for HIV Infection. AIDS Behav 22, 2008–2017 (2018). https://doi.org/10.1007/s10461-017-1828-0

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