Predictors and Consequences of Prescription Opioid Use in Women Living With and Without HIV: 20-Year Follow-Up
Year: 2022
Type: article
Study design: Observational Study
Abstract: Objective: To examine predictors and consequences of prescription opioid use among a cohort of women living with HIV (WLWH) and women without HIV from 2000 to 2019. Materials and Methods: The Women's Interagency HIV Study is a multisite, prospective cohort study. Cumulative proportion of visits with prescription opioid use was categorized as follows: minimal (0%–9%), intermediate (10%–39%), and chronic (>40%). Logistic regression examined independent predictors, and proportional hazards regression estimated unadjusted and adjusted hazards of all-cause mortality, comparing intermediate and chronic prescription opioid use with minimal use. Results: Annual prevalence of prescription opioid use significantly increased from 12.6% to 19.3% from 2000 to 2019 ( p < 0.0001). Prescription opioid use was minimal in 75%, intermediate in 16%, and chronic in 9% of women. WLWH had 56% higher odds of chronic prescription opioid use compared with women without HIV. Even after adjusting for quality-of-life scores including ratings of pain, women with intermediate and chronic prescription opioid use had greater odds of being sexual minorities (lesbian or bisexual), unemployed, and were more likely to report benzodiazepine and nonprescription substance use compared with those with minimal use. Intermediate and chronic prescription opioid use were each associated with an almost 1.5-fold increased risk of all-cause mortality. Conclusions: Despite federally mandated opioid prescribing guidelines, prescription opioid use and related mortality significantly increased in women experiencing physical and psychosocial vulnerabilities. The higher mortality rate found among prescription opioid users may reflect the many underlying chronic medical and psychosocial conditions for which these opioids were prescribed, as well as complications of opioids themselves. Findings underscore the need for non-opioid and nonpharmacological interventions for chronic pain, particularly in sexual minorities and WLWH. Avoiding concurrent use of opioids with benzodiazepines and nonprescription drugs might reduce mortality. Clinical Trial Registration Number: NCT00000797
Source: Journal of Women s Health
Institutions: John H. Stroger, Jr. Hospital of Cook County, Cook County Health and Hospitals System, Johns Hopkins University, Hektoen Institute, Albert Einstein College of Medicine, Georgetown University Medical Center, University of Alabama at Birmingham, SUNY Downstate Health Sciences University, New York University, University of California, Irvine, University of North Carolina at Chapel Hill, University of Miami
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Gilead Sciences, Georgia Clinical and Translational Science Alliance, National Institutes of Health, University of California, San Francisco, Center for AIDS Research, University of Alabama at Birmingham, National Institute on Alcohol Abuse and Alcoholism, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, National Institute of Dental and Craniofacial Research, Office of Research on Women's Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Center for AIDS Research, University of North Carolina at Chapel Hill
Awards: Emory WIHS CRS - Longitudinal Cohort, G311558797, The Connie Wofsy Women's HIV Study, Brooklyn Women's Interagency HIV Study (WIHS) V, Miami Womens Interagency HIV Study WIHS, G3869857964, G4371267688, WIHS Data Management and Analysis Center (WDMAC), Southern California Women's Interagency HIV Study Consortium, Chicago WIHS Consortium V (CWC), Washington Women's Interagency HIV/AIDS Study, Clinical and Translational Science Institute, G5900455136, Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, G6990385686, University of North Carolina Womens Interagency HIV Study UNC WIHS, G767062161, G775892330, G7807729167, Women's Interagency HIV Study (WIHS-V), G8846374971, UAB-MISS WIHS Cohort, G9000080293, G9000122276, SF Bay Area MACS/WIHS Combined Cohort Study, MACS/WIHS Combined Cohort Study: Cook County Clinical Research Site (CC_CRS), The University of North Carolina Center for AIDS Research, MACS/WIHS Combined Cohort Study: Brooklyn Clinical Research Site (Bklyn CRS), Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS), UAB Center for AIDS Research (CFAR)
OpenAlex ID: W4214689658