Prescription opioid use and opioid use disorder among older adults with HIV in the USA from 2008 to 2021: a retrospective repeated cross-sectional study

作者：Stephanie Shiau, Fabrizio Drago, Carolyn Waugh Kinkade, Kylie Getz, Greta Bushnell, Hillary Samples, Alexis A. Bender, Laura Bennett, Chintan V. Dave, Perry N. Halkitis, Tobias Gerhard, Jason Roy, Sílvia S. Martins, Michael T. Yin, Stephen Crystal · 发表于：The Lancet Primary Care · 年份：2025 · DOI：10.1016/j.lanprc.2025.100017 · 被引用次数：2 · 研究领域：HIV-related health complications and treatments、Opioid Use Disorder Treatment、HIV/AIDS Research and Interventions

Background: There is longstanding concern that people with HIV receive prescription opioids at higher rates and have a disproportionate burden of opioid use disorder (OUD) compared with their counterparts without HIV. We aimed to evaluate trends of opioid prescriptions and indicators of OUD in an understudied but growing population of older adults with HIV. Methods: For this retrospective repeated cross-sectional study, we constructed annual cohorts through a nationally representative sample of fee-for-service Medicare beneficiaries aged 65 years and older in the USA with Part D coverage (ie, prescription drug) enrolled between Jan 1, 2008, and Dec 31, 2021. Beneficiaries were eligible for inclusion in each cross-sectional cohort if they had reached the age of 65 years by Jan 1 of the calendar year and had 1 year of continuous Medicare enrolment in Part A (inpatient hospital care), B (outpatient care), and D. Beneficiaries with HIV were matched in a 1:3 ratio to beneficiaries without HIV on age, sex, race or ethnicity, US state, and dual eligibility status (Medicare and Medicaid). The main outcomes were receipt of at least one opioid prescription and any indicator of OUD (ie, formal diagnosis, medication for OUD, or opioid-related or emergency department visits) during each calendar year. Generalised estimating equations were used to estimate odds ratios (ORs) of each outcome, comparing matched beneficiaries with or without HIV. Due to data availability, our analysis of indic...