Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review

AIDS Care. 2016 Dec;28(12):1506-1515. doi: 10.1080/09540121.2016.1191612. Epub 2016 Jun 7.


Chronic pain occurs in as many as 85% of individuals with HIV and is associated with substantial functional impairment. Little guidance is available for HIV providers seeking to address their patients' chronic pain. We conducted a systematic review to identify clinical trials and observational studies that examined the impact of pharmacologic or non-pharmacologic interventions on pain and/or functional outcomes among HIV-infected individuals with chronic pain in high-development countries. Eleven studies met inclusion criteria and were mostly low or very low quality. Seven examined pharmacologic interventions (gabapentin, pregabalin, capsaicin, analgesics including opioids) and four examined non-pharmacologic interventions (cognitive behavioral therapy, self-hypnosis, smoked cannabis). The only controlled studies with positive results were of capsaicin and cannabis, and had short-term follow-up (≤12 weeks). Among the seven studies of pharmacologic interventions, five had substantial pharmaceutical industry sponsorship. These findings highlight several important gaps in the HIV/chronic pain literature that require further research.

Keywords: HIV; chronic pain; cognitive therapy; hypnosis; medical marijuana; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Analgesics / therapeutic use*
  • Chronic Pain / drug therapy
  • Chronic Pain / etiology
  • Chronic Pain / therapy*
  • Cognitive Behavioral Therapy
  • HIV Infections / complications*
  • Humans
  • Hypnosis
  • Marijuana Smoking*


  • Analgesics