title: Is HIV Painful? An Epidemiologic Study of the Prevalence and Risk Factors for Pain in HIV-infected Patients.
abstract: OBJECTIVE
  To evaluate the prevalence, impact, and risk factors for pain among a cohort of human immunodeficiency virus (HIV)-infected adults treated with combination antiretroviral therapy if indicated according to current guidelines.
  
  
  METHODS
  This was a cross-sectional epidemiological observational study. All patients attending 1 HIV-outpatient center in the United Kingdom in a 10-month period were eligible. Patients completed a validated questionnaire enquiring about demographics, HIV factors, and symptoms of pain.
  
  
  RESULTS
  Of 1050 eligible participants, 859 (82%) completed a questionnaire. The 1-month period prevalence of pain lasting >1 day was 62.8% among whom 63% reported current pain. The prevalence of pain at most anatomic sites was broadly similar to that observed in population studies using the same questionnaires except that we found considerably higher rates of foot/ankle pain. The median duration of pain was 3 years (range, 0 to 51 y) and the median pain score was 5.0 on an 11-point visual analogue score. Over 40% of people in pain had consulted their primary care physician and >20% were taking analgesics daily. Independent risk factors for current pain were older age (P=0.001), time since diagnosis of HIV infection (P=0.001), and receipt of a protease inhibitor-based regimen (P=0.04).
  
  
  CONCLUSIONS
  Pain, and notably foot/ankle pain, is common among adults living with prevalent HIV and is associated with substantial morbidity and health care utilization.
authors.affiliation: St John's Medical Centre.
authors.forename: Edwina
authors.initials: E
authors.lastname: Lawson
authors.affiliation: Research Department of Infection and Population Health, UCL, Royal Free Campus, London.
authors.forename: Caroline
authors.initials: C
authors.lastname: Sabin
authors.affiliation: Department of HIV/GU Medicine, Royal Sussex County Hospital.
authors.forename: Nicky
authors.initials: N
authors.lastname: Perry
authors.affiliation: Department of HIV/GU Medicine, Royal Sussex County Hospital.
authors.forename: Daniel
authors.initials: D
authors.lastname: Richardson
authors.affiliation: Department of HIV/GU Medicine, Royal Sussex County Hospital.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Gilleece
authors.affiliation: Department of HIV/GU Medicine, Royal Sussex County Hospital.
authors.forename: Duncan
authors.initials: D
authors.lastname: Churchill
authors.affiliation: Department of HIV/GU Medicine, Royal Sussex County Hospital.
authors.forename: Gillian
authors.initials: G
authors.lastname: Dean
authors.affiliation: Department of HIV/GU Medicine, Royal Sussex County Hospital.
authors.forename: Debbie
authors.initials: D
authors.lastname: Williams
authors.affiliation: Department of HIV/GU Medicine, Royal Sussex County Hospital.|Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton.
authors.forename: Martin
authors.initials: M
authors.lastname: Fisher
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Walker-Bone