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Member Research and Reports

Member Research and Reports

Rutgers Dean Proposes Paradigm for Managing HIV-Related Pain and Associated Substance Abuse in Older Adults

Rutgers School of Public Health Dean, Dr. Perry N. Halkitis along with Dr. Ramani Durvasula and their mentee Mr. Theodore R. Miller have proposed a new biopsychosocial model for addressing the complex associations between substance use, mental health, psychosocial issues, and chronic pain among pain among older persons living with HIV/AIDS (PLWHA).

Since the HIV epidemic of the 80s, the advent and uptake of effective antiviral therapies has transformed HIV/AIDS into a chronic manageable illness, where the majority of Americans living with the virus are now ages 50 and older. Given the confluence of aging and HIV, chronic pain among PLWHA has emerged as an area of clinical importance. Treatment of pain in this population is complex due to the prevalence of substance abuse and psychiatric illness, as well as, the challenges of disentangling how inflammation associated with aging and HIV interact to predispose pain.

The researchers developed a framework addressing the age-related chronic pain link in older PLWHA, which should be used when considering treatment of a population susceptible to both biological, psychological, and social factors that can magnify pain.

“It is critical that we address the unique health needs of the growing PLWHA population, through supportive therapies that increase overall health and quality of life,” comments Dr. Halkitis. “By 2020 70 percent of those living with HIV will be 50 and older. Due to biological, psychological, and social comorbidities presented by older HIV positive adults, we must ensure that we are providing the best standard of care to this vibrant and resilient population, which is why we propose this framework.”

The Rutgers School of Public Health is also focusing its annual community World AIDS Day commemoration on the topic of HIV, aging, and resilience, which Dean Halkitis first wrote about in his 2013 award-winning book, The AIDS Generation: Stories of Survival and Resilience.

This paradigm builds upon over a decade of research led by Dr. Halkitis and his team at the Center for Health, Identity, Behavior and Prevention Studies through their GOLD studies.

A Biopsychosocial Approach to Managing HIV-Related Pain and Associated Substance Abuse in Older Adults: A Review,” was recently published in Ageing International.