title: The role of chronic pain and current substance use in predicting negative social support among disadvantaged persons living with HIV/AIDS.
abstract: Chronic pain and substance use can strain the supportive relationships of persons with serious chronic illness, which may increase the likelihood of receiving negative, rather than positive, social support from informal caregivers and social network members. To our knowledge, this is the first study to longitudinally examine the effects of chronic pain and substance use on negative social support. The sample (N = 383) comprised disadvantaged, primarily African-American, persons living with HIV/AIDS with a history of injection drug use, 32.4% of whom reported frequent or constant pain in the prior 6 months. Using factor analysis and structural equation modeling, current substance use and greater levels of chronic pain positively predicted negative social support 12 months later, after controlling for baseline negative support, viral load, age and sex. We also found a significant interaction effect such that among those not using substances, there was a significant positive association between pain and negative support, but no such association among those currently using substances. The findings emphasize the importance of treatment of chronic pain and substance use in the supportive functioning of social networks of a disadvantaged population with serious chronic conditions and persistent health disparities.
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Mitchell
authors.affiliation: b Department of Surgery, Harvard School of Medicine, Harvard School of Public Health, Center for Surgery and Public Health , Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Allysha C
authors.initials: AC
authors.lastname: Maragh-Bass
authors.affiliation: c Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Trang Q
authors.initials: TQ
authors.lastname: Nguyen
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Sarina
authors.initials: S
authors.lastname: Isenberg
authors.affiliation: a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Knowlton
mesh_terms: D000328:Adult; D017028:Caregivers; D059350:Chronic Pain / Q000150:complications* / Q000628:therapy; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012944:Social Support; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000628:therapy; D035862:Vulnerable Populations
keywords: Chronic pain; HIV/AIDS; black/African-American; negative social support; substance/drug use