High levels of self-reported prescription opioid use by HIV-positive individuals

ABSTRACT

Prescription medication use (other than antiretroviral therapy (ART)) is highly prevalent among people living with HIV. Prescription medications may be used medically or non-medically: non-medical use includes using more medication than prescribed, using medication prescribed to someone else, or using medication for a purpose other than its prescribed use. During 12 weeks in 2014–2015, we characterized medical and non-medical prescription medication use among HIV-positive patients attending an academic medical center (n = 149) and a community clinic (n = 105). Separately for the past year and the past month, these 254 participants self-reported their use of prescription opioids, sedatives, stimulants, anti-anxiety medications, antipsychotic medications, and erectile dysfunction medications. Respondents were largely male (91%), aged 40 or older (61%), identified as gay or bisexual (79%), and were men who have sex with men (85%). ART use was nearly universal (95%). Nearly half (43%) of participants reported medical use of prescription opioids; 11% of the opioid use was reported as non-medical use. Anti-anxiety medication use was also frequent, and differed by site: 41% of community-clinic responders reported medical use of anti-anxiety medications compared to 23% of hospital clinic respondents who reported medical use. Prescription sedative use was also approximately twice as high among community-clinic participants, with medical use reported by 43% of respondents and non-medical use by 12%; in comparison, at the hospital clinic, sedative use was reported by 18% (medical) and 7% (non-medical) of participants. Stimulant use was rare in both sites. No demographic characteristic was significantly associated with medical or non-medical use of any prescription medication. The current focus of many studies on only non-medical prescription medication use not only underestimates the widespread exposure of HIV-positive individuals to these drugs, but may also underestimate potential adverse effects of prescription medications in this population.

KEYWORDS:

• HIV
• prescription medication
• opioids
• non-medical use
• medical use
• ART

Acknowledgments

The authors are grateful for the participation of clinic attendees and staff. The content of this article is solely the responsibility of the authors, and it does not necessarily represent the official views of the funding agencies.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCiD

Jesse J. Kwiek http://orcid.org/0000-0003-4277-8315

Additional information

Funding

This research was supported in part by NIH awards [AI090644 (JJK)], [HL108743 (NTF)], and [HL126563 (NTF)], and by the SOLAR Foundation Research Fund at The Ohio State University (BMS).