Estimating the prevalence and correlates of pain among people living with HIV who use unregulated drugs in a Canadian setting




pain, HIV, substance use, opioid analgesics, pain management


Although prevalent among people living with human immunodeficiency virus (HIV) (PLWH) and people who use unregulated drugs (PWUD), pain and its possible links to substance use patterns and engagement in HIV treatment remains poorly characterized. We sought to evaluate the prevalence and correlates of pain among a cohort of PLWH who use unregulated drugs. Between December 2011 and November 2018, 709 participants were recruited, and data were analyzed using generalized linear mixed-effects (GLMM). At baseline, 374 (53 percent) individuals reported moderate-to-extreme pain in the previous 6 months. In a multivariable model, pain was significantly associated with nonmedical prescription-opioid use (adjusted odds ratio (AOR) = 1.63, 95 percent confidence interval (CI): 1.30-2.05), nonfatal overdose (AOR = 1.46, 95 percent CI: 1.11-1.93), self-managing pain (AOR = 2.25, 95 percent CI: 1.94-2.61), requesting pain medication in the previous 6 months (AOR = 2.01, 95 percent CI: 1.69-2.38), and ever being diagnosed with a mental illness (AOR = 1.47, 95 percent CI: 1.11-1.94). Establishing accessible pain management interventions that address the complex intersection of pain, drug use, and HIV-infection has potential to improve quality of life outcomes among this population.

Author Biographies

Jane Loh, MSc

British Columbia Centre on Substance Use, School of Population and Public Health, University of British Columbia, Vancouver, Canada

Jane Buxton, MBBS, MHSc, FRCPC

Professor, School of Population and Public Health, University of British Columbia, British Columbia Centre for Disease Control, Vancouver, Canada

Angela Kaida, PhD

Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada

Pauline Voon, BSN, RN

Research Associate, British Columbia Centre on Substance Use, Vancouver, Canada

Cameron Grant, BSc

British Columbia Centre on Substance Use, Vancouver, Canada

M-J Milloy, PhD

British Columbia Centre on Substance Use, Department of Medicine, University of British Columbia, Vancouver, Canada


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How to Cite

Loh, MSc, J., J. Buxton, MBBS, MHSc, FRCPC, A. Kaida, PhD, P. Voon, BSN, RN, C. Grant, BSc, and M.-J. Milloy, PhD. “Estimating the Prevalence and Correlates of Pain Among People Living With HIV Who Use Unregulated Drugs in a Canadian Setting”. Journal of Opioid Management, vol. 19, no. 3, Apr. 2023, pp. 225-37, doi:10.5055/jom.2023.0778.




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