High prevalence of pain among adult HIV-infected patients at University of Gondar Hospital, Northwest Ethiopia

Abstract

Background

HIV/AIDS are pressing global health problems. Pain is a common symptom reported by patients living with HIV/AIDS. The exact cause of pain in HIV patients has not been thoroughly described, but it may, due to a symptom of HIV itself, result from opportunistic infections, as a side effect of antiretroviral drugs, concurrent neoplasia or other causes. In addition, pain perception of HIV-infected patients is highly variable and may vary based on cultural context and patient demographics. In Ethiopia, there is insufficient evidence on the prevalence and factors associated with HIV-related pain.

Methods

A cross-sectional study was conducted among 422 adult HIV-infected patients at Gondar University Hospital antiretroviral care clinic from March 1 to May 1, 2016. Systematic random sampling was used to select study participants. A pretested interviewer-administered questionnaire and a standardized medical record data abstraction tool were used to collect data. A short form brief pain inventory tool was used to measure the outcome. Bivariate and multivariate logistic regression models were fitted to identify factors associated with pain among adult HIV patients.

Results

The prevalence of pain was found to be 51.2% (95% CI: 46.4%–55.9%). Headache (17.9%), abdominal pain (15.6%), and backache (13.3%) were the most common symptoms of study participants. Being female (adjusted odds ratio [aOR]=1.8, 95% CI: 1.1–2.9); regular alcohol intake (aOR=3.3, 95% CI: 1.5–7.2); baseline World Health Organization clinical disease stage: II (aOR=2.5, 95% CI: 1.2–4.9), III (aOR=2, 95%, CI: 1.1–3.6), and IV (aOR=2.4, 95% CI: 1.1–5.3); and the presence of a chronic comorbid condition (aOR=5.9, 95% CI: 2.1–16.7) were significantly associated with pain.

Conclusion

Adult HIV patients in this sample reported a high level of chronic pain. Healthcare providers should better implement a routine pain assessment among HIV-positive patients to alleviate their suffering.

Keywords:

• human immunodeficiency virus
• acquired immune deficiency syndrome
• sub-saharan Africa
• Ethiopia
• pain
• prevalence

Acknowledgments

The authors thank the study participants and data collectors for their collaboration during the data collection. They acknowledge Dr Timothy Landers for his review and input in the manuscript.

Author contributions

AW conceived the idea and wrote the proposal, participated in the data collection process, analyzed the data and drafted the paper. HK, DZ and AD approved the proposal with some revisions, participated in data analysis and reviewed the manuscript. All authors revised the paper critically and approved the final draft of the manuscript.

Disclosure

The authors report no conflicts of interest in this work.