Non-pharmacologic approaches to managing chronic pain in persons living with HIV: a scoping review

Abstract Aim This scoping review maps existing evidence regarding non-pharmacologic interventions for management of chronic pain in persons living with HIV (PWH). We identified non-pharmacologic interventions, pain measurement tools, and non-pain outcomes used in clinical trials. Methods This review was conducted in accordance with the Joanna Briggs Institute framework. The search using keywords and Medical Subject Headings (MeSH) was performed across multiple databases, gray literature, and Google Scholar, with hand searches of select journals. We included primary research articles, review articles, and other types of reports. Two independent reviewers performed screening for inclusion and data extraction for included articles, with disagreements adjudicated by a third reviewer. Results We identified 151 articles that met our inclusion criteria, of which 47 (31%) were interventional clinical trials. Among those trials, the most frequently studied interventions were behavioral interventions ( n = 16), patient education ( n = 7), mind–body approaches ( n = 12), exercise ( n = 5), and cannabis ( n = 3). The most frequently used tool for pain assessment was the Brief Pain Inventory, used in 34% of the clinical trials. Most clinical trials (94%) reported an improvement in pain following the intervention; the improvement was statistically significant in 49% of the trials. The most frequently used non-pain outcomes were mental health, quality of life, and physical function. Conclusion Although results from clinical trials are mixed, several studies have reported that behavioral interventions, patient education, certain mind–body therapies, exercise, and cannabis decrease pain in PWH. Several other less-studied interventions may be promising.