Prescription Opioid Misuse, Pain Interference, Resilience, and Anxiety Among Chinese People Living with HIV: A Moderated Mediation Model

AIDS Behav. 2023 Oct;27(10):3508-3514. doi: 10.1007/s10461-023-04066-4. Epub 2023 Apr 19.

Abstract

Prescription opioid misuse (POM) is a concern in people living with HIV (PLWH). Pain interference is a robust factor, and its influences would occur through anxiety and resilience. Limited POM studies attend to Chinese PLWH. This study examined POM and its underlying psychological mechanism using data of PLWH with pain (n = 116) from a cohort study in Guangxi. The PROCESS macro was employed to examine a hypothesized moderated mediation model among pain interference, resilience, anxiety, and POM. Results showed 10.3% PLWH engaged in past-three-month POM. After controlling for demographics, HIV-related clinical outcomes, and pain severity, anxiety mediated the association between pain interference and POM (β = 0.46, 95% CI = 0.01 to 10.49), and the mediation was moderated by resilience (moderated mediation index = - 0.02, 95% CI = - 0.784 to - 0.001). Chinese PLWH seem to misuse opioids to cope with pain-related anxiety. Resilience appears to offer protection.

Keywords: Anxiety; China; Mediation; Moderation; Pain; People living with HIV; Prescription opioids; Resilience.

MeSH terms

  • Anxiety / epidemiology
  • China / epidemiology
  • Cohort Studies
  • East Asian People
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Opioid-Related Disorders* / complications
  • Opioid-Related Disorders* / epidemiology
  • Pain