title: Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia.
abstract: 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% <9th grade education. Nearly one quarter (24%) had a CD4 cell count <200 cells/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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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. Electronic address: judith.tsui@bmc.org.
authors.forename: Judith I
authors.initials: JI
authors.lastname: Tsui
authors.affiliation: 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; Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118-2605, USA.
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.affiliation: Data Coordinating Center, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118-2605, USA.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Coleman
authors.affiliation: 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.
authors.forename: Marlene C
authors.initials: MC
authors.lastname: Lira
authors.affiliation: Laboratory of Clinical Pharmacology of Addictions, First St. Petersburg Pavlov State Medical University, Lev Tolstoy Street 6/8, St. Petersburg 197022, Russia.
authors.forename: Elena
authors.initials: E
authors.lastname: Blokhina
authors.affiliation: 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.
authors.forename: Carly
authors.initials: C
authors.lastname: Bridden
authors.affiliation: Laboratory of Clinical Pharmacology of Addictions, First St. Petersburg Pavlov State Medical University, Lev Tolstoy Street 6/8, St. Petersburg 197022, Russia; Department of Addictions, Bekhterev Research Psychoneurological Institute, Bekhtereva Street 3, St. Petersburg 192019, Russia.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Krupitsky
authors.affiliation: 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; Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118-2605, USA.
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D012426:Russia / Q000453:epidemiology; D013997:Time Factors
keywords: HIV; Pain; Risky alcohol use; Russia