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Pain is associated with heroin use over time in HIV ‐infected R ussian drinkers
Author(s) -
Tsui Judith I.,
Cheng Debbie M.,
Coleman Sharon M.,
Blokhina Elena,
Bridden Carly,
Krupitsky Evgeny,
Samet Jeffrey H.
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12274
Subject(s) - cannabis , medicine , gee , heroin , odds ratio , confidence interval , confounding , generalized estimating equation , addiction , logistic regression , psychiatry , drug , statistics , mathematics
Aims To evaluate whether pain was associated with increased risk of using heroin, stimulants or cannabis among HIV ‐infected drinkers in R ussia. Design Secondary analysis of longitudinal data from the HERMITAGE study (HIV's Evolution in Russia—Mitigating Infection Transmission and Alcoholism in a Growing Epidemic), a behavioral randomized controlled trial, with data collected at baseline, 6‐month and 12‐month visits. Setting Recruitment occurred at HIV and addiction treatment sites in St P etersburg, R ussian F ederation. Participants Six hundred and ninety‐nine HIV ‐infected adult drinkers. Measurements The primary outcome was past month illicit drug use; secondary outcomes examined each drug (heroin, stimulants and cannabis) separately. The main predictor was pain that interfered at least moderately with daily living. General estimating equations ( GEE ) logistic regression models were used to evaluate the association between pain and subsequent illicit drug use, adjusting for potential confounders. Findings Participants reporting pain appeared to have higher odds of using illicit drugs, although the results did not reach statistical significance [adjusted odds ratio ( OR ) = 1.32; 95% confidence interval ( CI) = 0.99, 1.76, P = 0.06]. There was a significant association between pain and heroin use ( OR = 1.54; 95% CI = 1.11–2.15, P = 0.01) but not use of other drugs ( OR = 0.75; 95% CI = 0.40–1.40, P = 0.35 for stimulants and OR = 0.70; 95% CI = 0.45–1.07, P = 0.09 for cannabis). Conclusions HIV ‐infected Russian drinkers who report pain are more likely to use heroin over time than HIV ‐infected Russian drinkers who do not report pain. Pain may be an unrecognized risk factor for persistent heroin use with implications for HIV transmission in R ussia.