Acceptability of a Smartphone-Based Music Intervention for Chronic Pain and Problematic Opioid Use Among People with HIV: A Mixed-Methods Pilot Study

Chronic pain can be complicated by problematic opioid use, which may decrease engagement in care and HIV medication adherence. Pain-related anxiety and catastrophic thinking augment pain severity and interference while driving increased substance use. The acceptability and effect of a music-based smartphone application on negative affect and catastrophic thinking were evaluated in a mixed-methods study among persons living with HIV (PWH) with problematic opioid use and chronic pain. Participants (<i>N</i> = 16) completed a 10-min music listening session, quantitative assessment<i>,</i> and qualitative interview. Paired sample <i>t</i>-tests compared pre- and post-test scores of negative affect (Profile of Mood States-Short Form) and pain catastrophizing (Situational Pain Catastrophizing Scale) before and after music. Qualitative data were analyzed using within-case, across-case analysis. Negative affect significantly decreased after the music listening session (pre 8.3 ± 6.7 vs. post 1.8 ± 2.6; <i>p</i> = .0003), as did pain catastrophizing (pre 8.5 ± 4.3 vs. post 2.5 ± 3.4; <i>p</i> < .0001). Qualitatively, participants (<i>n</i> = 14) viewed the app-based music listening session as acceptable and potentially useful as an intervention or adjuvant for pain management and reduction of opioid use. Overall, a brief exposure to a novel music app produced significant improvements in negative affect and pain-related catastrophic thoughts among PWH with problematic opioid use and chronic pain. Future work should further explore the effects of music on pain and the use of illicit substances more broadly in this population.