{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T07:17:23Z","timestamp":1767856643509,"version":"3.49.0"},"reference-count":60,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,7,24]],"date-time":"2013-07-24T00:00:00Z","timestamp":1374624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2013,10]]},"abstract":"Abstract<\/jats:title>Aims<\/jats:title>To evaluate whether pain was associated with increased risk of using heroin, stimulants or cannabis among HIV<\/jats:styled-content>\u2010infected drinkers in R<\/jats:styled-content>ussia.<\/jats:p><\/jats:sec>Design<\/jats:title>Secondary analysis of longitudinal data from the HERMITAGE<\/jats:styled-content> study (HIV's Evolution in Russia\u2014Mitigating Infection Transmission and Alcoholism in a Growing Epidemic), a behavioral randomized controlled trial, with data collected at baseline, 6\u2010month and 12\u2010month visits.<\/jats:p><\/jats:sec>Setting<\/jats:title>Recruitment occurred at HIV<\/jats:styled-content> and addiction treatment sites in St P<\/jats:styled-content>etersburg, R<\/jats:styled-content>ussian F<\/jats:styled-content>ederation.<\/jats:p><\/jats:sec>Participants<\/jats:title>Six hundred and ninety\u2010nine HIV<\/jats:styled-content>\u2010infected adult drinkers.<\/jats:p><\/jats:sec>Measurements<\/jats:title>The primary outcome was past month illicit drug use; secondary outcomes examined each drug (heroin, stimulants and cannabis) separately. The main predictor was pain that interfered at least moderately with daily living. General estimating equations (GEE<\/jats:styled-content>) logistic regression models were used to evaluate the association between pain and subsequent illicit drug use, adjusting for potential confounders.<\/jats:p><\/jats:sec>Findings<\/jats:title>Participants reporting pain appeared to have higher odds of using illicit drugs, although the results did not reach statistical significance [adjusted odds ratio (OR<\/jats:styled-content>)\u2009=\u20091.32; 95% confidence interval (CI)\u2009=\u2009<\/jats:styled-content>0.99, 1.76, P<\/jats:italic>\u2009=\u20090.06]. There was a significant association between pain and heroin use (OR<\/jats:styled-content>\u2009=\u20091.54; 95% CI<\/jats:styled-content>\u2009=\u20091.11\u20132.15, P<\/jats:italic>\u2009=\u20090.01) but not use of other drugs (OR<\/jats:styled-content>\u2009=\u20090.75; 95% CI<\/jats:styled-content>\u2009=\u20090.40\u20131.40, P<\/jats:italic>\u2009=\u20090.35 for stimulants and OR<\/jats:styled-content>\u2009=\u20090.70; 95% CI<\/jats:styled-content>\u2009=\u20090.45\u20131.07, P<\/jats:italic>\u2009=\u20090.09 for cannabis).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>HIV<\/jats:styled-content>\u2010infected Russian drinkers who report pain are more likely to use heroin over time than HIV<\/jats:styled-content>\u2010infected Russian drinkers who do not report pain. Pain may be an unrecognized risk factor for persistent heroin use with implications for HIV<\/jats:styled-content> transmission in R<\/jats:styled-content>ussia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12274","type":"journal-article","created":{"date-parts":[[2013,6,17]],"date-time":"2013-06-17T08:53:57Z","timestamp":1371459237000},"page":"1779-1787","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Pain is associated with heroin use over time in HIV<\/scp>\u2010infected R<\/scp>ussian drinkers"],"prefix":"10.1111","volume":"108","author":[{"given":"Judith I.","family":"Tsui","sequence":"first","affiliation":[{"name":"Department of Medicine Section of General Internal Medicine Clinical Addiction Research and Education (CARE) Unit Boston University School of Medicine\/Boston Medical Center Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie 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