title: Using Patient Perspectives to Inform the Development of a Behavioral Intervention for Chronic Pain in Patients with HIV: A Qualitative Study.
abstract: Chronic pain is a common and disabling comorbidity in individuals living with HIV. Behavioral interventions are among the most effective and safe nonpharmacologic treatments for chronic pain. However, the success of a behavioral intervention is influenced by how well it is tailored to the target population's biological, psychological, and social context. Given well-documented psychosocial vulnerabilities among persons with HIV, it is critical to develop a behavioral intervention for chronic pain tailored to this population.
  
  
  
  To use qualitative methods to investigate patient preferences for the structure and delivery of a behavioral intervention for chronic pain in individuals with HIV.
  
  
  
  Interviews and focus groups were used to elicit participant preferences. A thematic analysis approach, with an initial round of open coding, was used to develop the codebook and analyze the data.
  
  
  
  Qualitative data from 12 interviews and 3 focus groups with patients living with HIV and chronic pain (total N = 24) were analyzed. Emergent themes fell into four major categories: perceived value of group sessions, incorporating peer leadership, and two key elements of how the intervention should be delivered: the HIV status of group participants and views on phone-delivered intervention content.
  
  
  
  This study provides a framework for the structure and delivery of a behavioral intervention for chronic pain in individuals with HIV based on patient preferences. We will use these results to design our intervention, and hope that our approach informs the work of investigators in other disciplines who seek to incorporate patient preferences during intervention development.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.|Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Merlin
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Young
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, California, USA.
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Saag
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: William
authors.initials: W
authors.lastname: Demonte
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Riddhi
authors.initials: R
authors.lastname: Modi
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Shurbaji
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Anderson
authors.affiliation: Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, New Haven, Connecticut, USA.|Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, Connecticut, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Kerns
authors.affiliation: VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA|Department of Medicine, Division of General Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.|Regenstrief Institute, Indianapolis, Indiana, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Bair
authors.affiliation: Birmingham VA Medical Center, Birmingham, Alabama, USA.|Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kertesz
authors.affiliation: Department of Health Behavior, School of Public Health, University of Alabama, Birmingham, Alabama, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Davies
authors.affiliation: Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Turan
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D059350:Chronic Pain / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D036301:Qualitative Research; D016896:Treatment Outcome
keywords: Chronic Pain; Group Interventions; HIV; Patient Preferences; Peer Interventions