Chronic pain and pain management strategies among people living with HIV who use unregulated drugs in Canada
department or school: Medicine, Faculty of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Loh, Jane M.
issued: 2021-01-06T18:15:37Z
issued: 2020
related degree: Master of Science - MSc
degree grantor: University of British Columbia
description: Background: Although chronic pain is prevalent among people who use drugs (PWUD) and people living with HIV (PLWH), there have been few investigations of pain among PLWH who use drugs. To fill this gap, this thesis sought to evaluate the prevalence and correlates associated with chronic pain, analyze the associations of pain medication denial, and explore common pharmacologic and non-pharmacologic pain self-management strategies among PLWH who use drugs. Methods: Data were derived from the AIDS Care Cohort to Evaluate exposure to Survival Services (ACCESS) study, an open prospective cohort study of HIV-positive people who use drugs linked to comprehensive HIV clinical data. Generalized linear mixed-effects modelling (GLMM) was used to estimate the prevalence of and identify exposures linked to chronic pain (study 1) and to analyze associations of pain management strategies with substance use and socio-structural exposures (study 3). Generalized estimating equations (GEE) were used to explore the independent relationships between pain medication denial with various substance use, social-, and healthcare access measures (study 2). Results: In study 1, 374 (53%) participants reported recent moderate-to-extreme pain. Multivariable GLMM analysis revealed chronic pain was associated with pain self-management, non-fatal overdose, non-medical prescription opioid use, and mental illness. Being denied pain medication was reported by 84 (20%) participants in study 2. In a multivariable GEE model, recent pain medication denial was associated with recent incarceration, daily cocaine injection, pain self-management, attempted suicide, and not visiting a family physician. In study 3, pain self-management was reported by 342 (70%) participants; multivariable GLMM identified associations with homelessness, daily injection heroin and non-medical prescription opioid use, and being diagnosed with a chronic pain condition. Self-management strategies primarily involved illicit substances…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/76963
note: CHRONIC PAIN AND PAIN MANAGEMENT STRATEGIES AMONG PEOPLE LIVING WITH HIV WHO USE UNREGULATED DRUGS IN CANADA by Jane M. Loh B.A. (Health Sciences), Simon Fraser University, 2015 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) January 2021 © Jane M. Loh, 2021 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the thesis entitled: CHRONIC PAIN AND PAIN MANAGEMENT STRATEGIES AMONG PEOPLE LIVING WITH HIV WHO USE UNREGULATED DRUGS IN CANADA submitted by Jane M. Loh in partial fulfillment of the requirements for the degree of Master of Science in Population and Public Health Examining Committee: M-J Milloy, Department of Medicine, UBC Co-Supervisor Jane Buxton, School of Population and Public Health, UBC Co-Supervisor Angela Kaida, Faculty of Health Sciences, SFU Committee Member Joseph Puyat, School of Population and Public Health, UBC Additional Examiner iii Abstract Background: Although chronic pain is prevalent among people who use drugs (PWUD) and people living with HIV (PLWH), there have been few investigations of pain among PLWH who use drugs. To fill this gap, this thesis sought to evaluate the prevalence and correlates associated with chronic pain, analyze the associations of pain medication denial, and explore common pharmacologic and non-pharmacologic pain self-management strategies among PLWH who use drugs. Methods: Data were derived from the AIDS Care Cohort to Evaluate exposure to Survival Services (ACCESS) study, an open prospective cohort study of HIV-positive people who use drugs linked to comprehensive HIV clinical data. Generalized linear mixed-effects modelling (GLMM) was used to estimate the prevalence of and identify exposures linked to chronic pain (study 1) and to analyze associations…
has type: Thesis/Dissertation
date issued: 2021-05
is shown at: 10.14288/1.0395479
language: eng
degree discipline: Population and Public Health
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
type: Text
identifier URI: http://hdl.handle.net/2429/76963