Provider opioid prescribing practices and the belief that opioids keep people living with HIV engaged in care: a cross-sectional study

ABSTRACT

We describe HIV providers’ opioid prescribing practices and assess whether belief that chronic opioid therapy (COT) keeps people living with HIV (PLWH) engaged in care is associated with differences in these practices among providers from two HIV clinics. We conducted logistic regression to evaluate the association between the belief that COT keeps PLWH engaged in care and at least one component of guideline-recommended care (i.e., urine drug tests, treatment agreements, and/or prescription monitoring program use). The sample included 41 providers with a median age of 42 years, 63% female, 37% non-white. Routine adherence to guideline-recommended practices was: 34% urine drug tests, 27% treatment agreements, and 17% prescription monitoring program. Over half [54%] agreed that COT keeps PLWH engaged in care. There was no significant association between belief that COT keeps PLWH engaged in care and routinely providing any recommended COT care component (aOR 2.38; 95% CI 0.65–8.73). Most HIV providers do not routinely follow guidelines for opioid prescribing. We observed a positive association between belief that COT keeps PLWH engaged in care and following any guideline-recommended prescribing practices, although the result was not statistically significant. Interventions are needed to improve guideline-concordant care for COT by HIV providers.

KEYWORDS:

• HIV
• pain
• chronic pain
• analgesics
• opioids
• opioid-related disorders
• physicians

Acknowledgments

We would like to thank the study team as well as all participants in this study for their contributions.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse [grant number R01DA037768], the Center for AIDS Research at Emory University [grant number P30AI050409], and the Providence/Boston Center for AIDS Research [grant number P30AI042853], which are both supported by the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, or the National Institutes of Health; Center for AIDS Research, Emory University; Center for AIDS Research, Providence/Boston.