Engagement in HIV care and viral suppression following changes in long-term opioid therapy for treatment for chronic pain
Skip to main content
eScholarship
Open Access Publications from the University of California

UCSF

UC San Francisco Electronic Theses and Dissertations bannerUCSF

Engagement in HIV care and viral suppression following changes in long-term opioid therapy for treatment for chronic pain

  • Author(s): Silvis, Janelle
  • Advisor(s): Lewtwyler, Heather
  • et al.
Abstract

Objectives: To determine associations between dose changes in opioids prescribed for chronic non-cancer pain and HIV care outcomes. Methods: Using medical record data from January 1, 2012, to June 30, 2019, for 300 publicly insured HIV-positive primary care patients prescribed opioids for chronic non-cancer pain in San Francisco, we examined associations between opioid dose changes and both time to disengagement from HIV care and having a detectable viral load using logistic regression models. Models controlled for time-dependent confounding and informative censoring using inverse probability of treatment and retention weights, respectively. Results: Discontinuation of prescribed opioids was associated with increased odds of disengagement in care at 3 months (OR: 2.21, 95% CI: 1.19-4.12), 6 months (3.66, 1.94-6.93), and 9 months (3.75, 1.76-7.97) after discontinuation. An increased opioid dose was associated with lower odds of having a detectable viral load (0.64, 0.43-0.95). Conclusions: Discontinuation of opioids prescribed for chronic pain is associated with disengagement from HIV care. Policy Implications: Providers and policymakers must consider the unintended consequences of opioid stewardship and its potential impacts on retention in care.

Main Content
For improved accessibility of PDF content, download the file to your device.
Current View