Exploring the Intersection of Race, Chronic Pain, Substance Use, and Overdose among People Living with HIV: A Mediation Analysis

As people living with HIV (PLWH) live longer due to effective antiretroviral therapy (ART), new health issues, such as chronic pain, have emerged. Research shows that PLWH with chronic pain may struggle with ART adherence and are at increased risk for substance use disorders and overdoses. However, there is limited knowledge on how chronic pain and overdose are connected in PLWH, especially if substance use disorders mediate this link. This project aims to close this gap. I hypothesize that PLWH who experience chronic pain are more likely to use illicit substances, which in turn increases their risk of substance use disorder and subsequent overdose.

Using data from the Comparative Outcomes and Service Utilization Trends (COAST) study, which includes comprehensive health data on all PLWH in British Columbia, this project will:

Analyze if PLWH with chronic pain are more likely to develop substance use disorders, potentially increasing overdose risk.
Assess whether racialized PLWH face greater overdose risk due to compounded challenges with chronic pain and substance use than White PLWH.
Develop knowledge translation guidelines to improve health outcomes for PLWH experiencing chronic pain and overdose.