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Ongoing pain despite aggressive opioid pain management among persons with HIV

John Koeppe1, Carl Armon, Karen Lyda

  • 1Division of Infectious Diseases, Departments of Medicine, University of Colorado Denver, Aurora, CO 80045, USA. john.koeppe@uchsc.edu

The Clinical Journal of Pain
|February 23, 2010
PubMed

Insights

Opioid use for chronic pain in people with HIV is linked to psychosocial factors and a history of AIDS. Patients on opioids still report higher pain levels, indicating limited efficacy.

Area of Science:

  • Pain Management
  • Infectious Diseases
  • Public Health

Background:

  • Chronic pain is prevalent in individuals with Human Immunodeficiency Virus (HIV).
  • Opioids are commonly prescribed for managing chronic pain in this population.
  • Limited data exist on factors influencing opioid use and its effectiveness in HIV patients.

Purpose of the Study:

  • To investigate variables associated with opioid use for chronic pain in persons with HIV.
  • To assess the efficacy of opioid therapy in managing chronic pain among HIV-positive individuals.

Main Methods:

  • A cross-sectional cohort study was conducted in 2005.
  • Patients were categorized into three groups: daily opioid therapy for chronic pain, chronic pain without daily opioids, and no chronic pain diagnosis.
  • Self-reported pain data were collected and analyzed.

Main Results:

  • Opioid users were more likely to use benzodiazepines/gamma-aminobutyric receptor agonists, have a history of injection drug use, lack private insurance, report abuse, have a history of AIDS, and attend appointments more frequently.
  • Patients on opioid therapy reported significantly higher pain scores (4.3 vs. 1.9 vs. 0.7) and greater pain severity (58.6% vs. 15.5% vs. 4.9%).

Conclusions:

  • Psychosocial factors and a history of AIDS are associated with opioid prescribing in HIV patients.
  • Opioid therapy did not resolve pain, as patients on these medications continued to report higher pain levels.
Abstract

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