Pain in women with HIV/AIDS

Poor women and women of color are disproportionately affected by HIV and this is particularly evident in sub-Saharan Africa. Even with increased access to antiretroviral therapy that makes HIV/AIDS a chronic manageable condition, little progress has been made to address the issues of pain caused by HIV disease in women. Women experience pain differently from men due to biological, psychological, and social factors. Despite a high prevalence of pain associated with HIV disease, pain is usually under-diagnosed and poorly treated. HIV-related pain is usually divided into two categories: nociceptive or neuropathic. Lack of knowledge of health care providers and reluctance to prescribe potent medication or antidepressants concomitantly to relieve pain contribute to the inadequate management of pain. In poor settings, the weak public health infrastructure with its limited human resources and inadequate drug supplies make high-quality palliative and end-of-life care virtually impossible. As the existing hospital infrastructure is unable to manage the large number of AIDS-related deaths, community-based palliative and end-of-life care models are urgently required. Health care providers in the developing world require training on basic pharmacology and effective analgesic care. An improved ability to assess pain and a greater understanding of HIV-specific pain syndromes and their mechanisms will enable health care providers to better alleviate pain in women. Unless the conditions under which women live are addressed, and attempts made to empower them in their daily lives, their limited ability to access treatment, care and pain relief will continue to be unacceptable.