Pain

Background

While pain has been identified as a prevalent and burdensome problem in PLWH, little research into it exists in the modern ART era – most of our knowledge about pain in HIV derives from an era when individuals were receiving ART drugs that are no longer currently in use.  We know very little about how prevalent pain is among individuals receiving modern ART regimens, now what the causes of pain are likely to be in this group.  Without this information, it is difficult to make recommendations for how to manage pain in this population.    

Study aims

Pain mannequins, and pain questionnaires, are completed by participants during POPPY visits along with several questions about the prevalence and impact of pain.  We will describe the prevalence of each of these measures of pain, overall and stratified by POPPY group.  Where possible (based on resource use data) we will subdivide pain into that which is acute or due to a known specific cause, to that which is chronic and more generalised (or with no known underlying cause). 

Work to date

We have already conducted a detailed systematic review on the different approaches that can be taken for the self-management of pain among PLWH.  We have also described the one-month prevalence of pain, moderate or severe pain and current pain among POPPY participants and have shown that even in the modern ART era, older PLWH continue to experience higher rates of pain than similarly-aged HIV-negative participants or younger PLWH.  We also found strong associations between pain and depression and poorer quality of life, both in older and younger PLWH.

Next steps

Analyses on pain continue in the cohort.  The pain mannequins are currently being coded, which will allow more detailed analyses of the site of pain among PLWH.

Study group

Richard Harding (Kings College Hospital), Kennedy Nkhoma (Kings College Hospital), Caroline Sabin (UCL), Alan Winston (Imperial College London).   Contact Caroline Sabin (c.sabin@ucl.ac.uk).