Features and Assessments of Pain, Anaesthesia, and Analgesia - Chapter 26: Pain and HIV

The burden of chronic pain is reported by an alarmingly high number of people living with HIV (PWH) in the United States, affecting up to 85% of PWH compared to only 11% of the general population. In addition, PWH are more likely than the general population to receive long-term opioid analgesic therapy. Both chronic pain and opioid use among PWH have been associated with profound psychological and functional morbidity and reduced retention in HIV primary care, suggesting a need to explore nonopiate treatment modalities for chronic pain in this population. The efficacy of nonpharmacological approaches to chronic pain such as physical therapy deserves careful consideration, but has been understudied among PWH. This chapter will provide an overview of current pain trends among PWH, treatment guidelines, and suggestions for how to best fulfill the needs to decrease pain, prevent opioid misuse, and improve quality of life for this unique patient population.