Receipt of Opioid Analgesics by HIV-Infected and Uninfected Patients

There is limited data on receipt and use of prescription opioids, often prescribed for pain, by HIV-infected (HIV+) patients. This cross-sectional study examined opioid analgesic receipt in HIV+ and uninfected patients to identify whether receipt varies by HIV status and to identify factors associated with opioid receipt.

After adjustment, HIV+ patients were 40 percent more likely to receive opioids than uninfected patients.

Using data from the Veterans Aging Cohort Study, the study included HIV+ patients receiving Veterans Health Administration (VHA) care and matched uninfected controls, for a sample of 78,748 patients. Pain-related diagnoses were determined using ICD-9 codes.

Key Findings:

  • Of the 23,651 HIV+ patients, 31 percent received opioids. Of the 55,097 uninfected patients, 28 percent received opioids.
  • HIV+ patients were more likely to have an acute pain diagnosis (7% versus 4%), but less likely to have a chronic pain diagnosis (53% versus 69%).
  • After adjustment, HIV+ patients were 40 percent more likely to receive opioids than uninfected patients.
  • HIV+ patients prescribed opioids had an increased prevalence of Hepatitis C Virus, major depression, alcohol and drug use disorders, and pain-related diagnoses as compared to their age/sex/race/ethnicity/site-matched controls.

More research should address potential condition under-reporting, and VHA pharmacy data limitations. Additionally, future research should investigate ways to standardize documentation of pain diagnoses, dosing, and duration of opioids in all clinical settings to better understand their prescription and use.