Drug and Alcohol Dependence 144 (2014) 87–92
Contents lists available at ScienceDirect
Drug and Alcohol Dependence journal homepage: www.elsevier.com/locate/drugalcdep
Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia Judith I. Tsui a,∗ , Debbie M. Cheng a,b , Sharon M. Coleman c , Marlene C. Lira d , Elena Blokhina e , Carly Bridden d , Evgeny Krupitsky e,f , Jeffrey H. Samet a,g a Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118-2605, USA b Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118-2605, USA c Data Coordinating Center, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118-2605, USA d Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118-2605, USA e Laboratory of Clinical Pharmacology of Addictions, First St. Petersburg Pavlov State Medical University, Lev Tolstoy Street 6/8, St. Petersburg 197022, Russia f Department of Addictions, Bekhterev Research Psychoneurological Institute, Bekhtereva Street 3, St. Petersburg 192019, Russia g Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118-2605, USA
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Article history: Received 2 April 2014 Received in revised form 17 August 2014 Accepted 18 August 2014 Available online 29 August 2014 Keywords: Risky alcohol use Pain HIV Russia
a b s t r a c t Background: 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. Methods: 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. Results: Baseline characteristics of participants (n = 699) were mean age of 30 (SD ±5) years, 41% female, and 22%
Contents lists available at ScienceDirect
Drug and Alcohol Dependence journal homepage: www.elsevier.com/locate/drugalcdep
Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia Judith I. Tsui a,∗ , Debbie M. Cheng a,b , Sharon M. Coleman c , Marlene C. Lira d , Elena Blokhina e , Carly Bridden d , Evgeny Krupitsky e,f , Jeffrey H. Samet a,g a Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118-2605, USA b Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118-2605, USA c Data Coordinating Center, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118-2605, USA d Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118-2605, USA e Laboratory of Clinical Pharmacology of Addictions, First St. Petersburg Pavlov State Medical University, Lev Tolstoy Street 6/8, St. Petersburg 197022, Russia f Department of Addictions, Bekhterev Research Psychoneurological Institute, Bekhtereva Street 3, St. Petersburg 192019, Russia g Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118-2605, USA
a r t i c l e
i n f o
Article history: Received 2 April 2014 Received in revised form 17 August 2014 Accepted 18 August 2014 Available online 29 August 2014 Keywords: Risky alcohol use Pain HIV Russia
a b s t r a c t Background: 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. Methods: 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. Results: Baseline characteristics of participants (n = 699) were mean age of 30 (SD ±5) years, 41% female, and 22%
