Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia

• Published in: Drug and alcohol dependence Vol. 144; pp. 87 - 92
• Main Authors: Tsui, Judith I., Cheng, Debbie M., Coleman, Sharon M., Lira, Marlene C., Blokhina, Elena, Bridden, Carly, Krupitsky, Evgeny, Samet, Jeffrey H.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.11.2014
• Subjects: Adult; Alcohol Drinking - epidemiology; Alcohol Drinking - psychology; Alcoholism - epidemiology; Alcoholism - psychology; Cohort Studies; Female; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - psychology; Humans; Longitudinal Studies; Male; Middle Aged; Pain; Pain - diagnosis; Pain - epidemiology; Pain - psychology; Psychiatry; Risky alcohol use; Russia; Russia - epidemiology; Time Factors; Russia; Pain; Risky alcohol use; HIV; Russia
• ISSN: 0376-8716; 1879-0046; 1879-0046
• DOI: 10.1016/j.drugalcdep.2014.08.013

•This study examined the association between pain and risky alcohol use over time in a cohort of HIV-infected Russian drinkers.•Nearly half (46%) reported at least moderate pain interference in the past month and 81% were drinking risky amounts.•Patients who reported at least moderate pain interference were more likely to report risky drinking over time. Pain is highly prevalent among persons with HIV. Alcohol may be used to “self-medicate” pain. This study examined the association between pain and risky alcohol use over time in a cohort of HIV-infected Russian drinkers. This secondary analysis utilized longitudinal data from a randomized trial of a behavioral intervention. Subjects included HIV-infected adults who reported past 6-month risky drinking and unprotected sex and were recruited from HIV and addiction treatment sites in St. Petersburg, Russia. The main independent variable was pain that at least moderately interfered with daily living. The primary outcome was past month risky drinking amounts based on NIAAA guidelines. General estimating equations (GEE) logistic regression models were used to calculate odds ratios and 95% confidence intervals for the association between pain and risky drinking over time (i.e., baseline, 6 and 12 months), adjusting for potential confounders. Baseline characteristics of participants (n=699) were mean age of 30 (SD ±5) years, 41% female, and 22% <9th grade education. Nearly one quarter (24%) had a CD4 cell count <200cells/μl, and only 17% were on antiretroviral therapy. Nearly half (46%) reported at least moderate pain interference in the past month and 81% were drinking risky amounts. In adjusted longitudinal GEE models, pain was significantly associated with greater odds of reporting past month risky drinking (AOR=1.34, 95% CI: 1.05–1.71, p value=0.02). Among a cohort of HIV-infected Russian drinkers, pain that at least moderately interfered with daily living was associated with higher odds of reporting risky drinking amounts over time.