AIDS and Behavior

, Volume 22, Issue 6, pp 2008–2017 | Cite as

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

  • Anjali Sharma
  • Donald R. Hoover
  • Qiuhu Shi
  • Jennie C. I. Tsao
  • Christopher Cox
  • Deborah R. Gustafson
  • Kathleen Weber
  • Ruth M. Greenblatt
  • Bradley E. Aouizerat
  • Michael W. Plankey
Original Paper


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.


Pain HIV Women Opioid 



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).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

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.

Informed Consent

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


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Anjali Sharma
    • 1
  • Donald R. Hoover
    • 2
  • Qiuhu Shi
    • 3
  • Jennie C. I. Tsao
    • 4
  • Christopher Cox
    • 5
  • Deborah R. Gustafson
    • 6
  • Kathleen Weber
    • 7
  • Ruth M. Greenblatt
    • 8
  • Bradley E. Aouizerat
    • 9
  • Michael W. Plankey
    • 10
  1. 1.Department of MedicineAlbert Einstein College of MedicineBronxUSA
  2. 2.Department of StatisticsRutgers UniversityPiscatawayUSA
  3. 3.Department of Epidemiology and Community HealthNew York Medical CollegeValhallaUSA
  4. 4.Department of Pediatrics, David Geffen School of MedicineUniversity of California Los AngelesLos AngelesUSA
  5. 5.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  6. 6.Department of NeurologyState University of New York Downstate Medical CenterBrooklynUSA
  7. 7.Department of MedicineJohn H. Stroger Jr. Hospital of Cook County/Hektoen Institute of MedicineChicagoUSA
  8. 8.Department of Clinical PharmacyUniversity of California San Francisco School of PharmacySan FranciscoUSA
  9. 9.Department of Oral and Maxillofacial SurgeryNew York University College of DentistryNew YorkUSA
  10. 10.Department of MedicineGeorgetown University Medical CenterWashingtonUSA

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