Abstract
Chronic pain (CP) is common among people with HIV (PWH), yet its prevalence and associated factors in those receiving modern, virally suppressive antiretroviral therapy (ART) are not well understood. This prospective observational study compared CP frequency and associated outcomes between PWH and people without HIV (PWoH). Participants (40 PWH, 23 PWoH) completed a questionnaire assessing daily pain lasting more than three months. Additional data included pain intensity, interference with daily activities, opioid use, and depressed mood (Beck Depression Inventory-II), as well as HIV clinical markers and comorbidities. Groups were demographically similar; all PWH were virally suppressed, with a mean HIV duration of 27.0 years, median nadir CD4 count of 173 cells/μL, and median current CD4 count of 644 cells/μL. CP was significantly more frequent in PWH (60%) than in PWoH (22%; OR = 5.40, 95% CI [1.67, 17.50]; p = 0.003). Among PWH, CP was associated with greater daily activity interference, higher opioid use, and increased neuropathic pain symptoms. PWH with CP also had higher BDI-II scores, indicating worse mood. These findings suggest that CP remains prevalent and disabling among PWH despite effective modern-day ART, underscoring the need for targeted pain assessment and management in this population.
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This work was supported by an award funding the HIV Neurobehavioral Research Center (HNRC) (P30MH062512). Tyler R. Bell’s work on this project was supported by K01AG081559.
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The study was approved by the local Ethics Committee of the University of California San Diego, and was conducted in accordance with the Declaration of Helsinki. All participants gave informed consent for their participation in the study.
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Ellis, R.J., Heaton, R.K., Atkinson, J.H. et al. Chronic pain in a modern virally suppressed HIV cohort is associated with disability and poorer mental health. Sci Rep (2026). https://doi.org/10.1038/s41598-026-52912-x
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DOI: https://doi.org/10.1038/s41598-026-52912-x
