Brief Report: Longitudinal Opioid Use Among HIV-Infected Patients, 2000 to 2014

Area of Science:

• Public Health
• Infectious Diseases
• Pharmacology

Background:

• Longitudinal opioid prescription patterns are not well understood in human immunodeficiency virus (HIV)-infected populations.
• Understanding these patterns is crucial for managing co-occurring conditions and treatment adherence in HIV care.

Purpose of the Study:

• To identify distinct longitudinal trajectories of opioid prescription use among HIV-infected patients.
• To examine the baseline characteristics associated with these opioid use trajectories.
• To assess the impact of time in HIV care on opioid prescription patterns.

Main Methods:

• Group-based trajectory modeling was employed to identify distinct opioid use patterns.
• Multinomial logistic regression was used to analyze associations between baseline characteristics and identified trajectories.
• Data were collected from 1239 HIV-infected participants in the UNC CFAR HIV Clinical Cohort between 2000 and 2014.

Main Results:

• Three distinct opioid use trajectories were identified: never/sporadic use (72%), episodic use (11%), and chronic use (16%).
• Episodic opioid use was associated with female sex, depression, drug-related diagnoses, antiretroviral therapy use, and undetectable HIV RNA.
• Chronic opioid use was associated with older age, female sex, and mental health diagnoses.
• Opioid prescription use significantly decreased with longer duration of HIV care for both episodic and chronic users.

Conclusions:

• Distinct opioid use trajectories exist among HIV-infected patients, influenced by demographic, clinical, and mental health factors.
• Opioid prescription use declines over time in HIV care, suggesting potential for effective management strategies.
• Further research should explore interventions to optimize pain management and reduce long-term opioid reliance in this population.