A qualitative study of the experience and impact of neuropathic pain in people living with HIV

Whitney Scott, Maite Garcia Calderon Mendoza Del Solar, Harriet Kemp, Lance M McCracken, Amanda C de C Williams, Andrew S C Rice, Whitney Scott, Maite Garcia Calderon Mendoza Del Solar, Harriet Kemp, Lance M McCracken, Amanda C de C Williams, Andrew S C Rice

Abstract

Painful distal symmetrical polyneuropathy is common in HIV and is associated with reduced quality of life. Research has not explored the experience of neuropathic pain in people with HIV from a person-centred perspective. Therefore, a qualitative interview study was conducted to more deeply understand the experience and impact of neuropathic pain in this population. Semistructured interviews were conducted with 26 people with HIV and peripheral neuropathic pain symptoms. Interviews explored the impact of pain and participants' pain management strategies. Interviews were transcribed verbatim and analysed using thematic analysis. Four themes and 11 subthemes were identified. Theme 1 reflects the complex characterisation of neuropathic pain, including the perceived unusual nature of this pain and diagnostic uncertainty. Theme 2 centred on the interconnected impacts of pain on mood and functioning and includes how pain disrupts relationships and threatens social inclusion. Theme 3 reflects the struggle for pain relief, including participants' attempts to "exhaust all options" and limited success in finding lasting relief. The final theme describes how pain management is complicated by living with HIV; this theme includes the influence of HIV stigma on pain communication and pain as an unwanted reminder of HIV. These data support the relevance of investigating and targeting psychosocial factors to manage neuropathic pain in HIV.

Conflict of interest statement

A.S.C. Rice undertakes consultancy and advisory board work for Imperial College Consultants. In the past 24 months, this has included remunerated work for: Pharmanovo, Galapagos, Toray, Quartet, Lateral, Novartis, Pharmaleads, Mundipharma, Orion, Asahi Kasei, and Theranexis, outside the submitted work. A.S.C. Rice was the owner of share options in Spinifex Pharmaceuticals from which personal benefit accrued upon the acquisition of Spinifex by Novartis in July 2015. In addition, Professor Rice has the following patents pending: Rice ASC, Vandevoorde S, and Lambert DM Methods using N-(2-propenyl)hexadecanamide and related amides to relieve pain WO 2005/079771, and Okuse et al. Methods of treating pain by inhibition of vgf activity EP13702262.0/WO2013 110945. The remaining authors have no conflicts of interest to declare.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
Summary of themes, subthemes, and their inter-relationships.

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