All ETDs from UAB

Advisory Committee Chair

Burel Goodin

Advisory Committee Members

Jessica Merlin

Bulent Turan

Document Type

Thesis

Date of Award

2017

Degree Name by School

Master of Arts (MA) College of Arts and Sciences

Abstract

Due to medical advancements in antiretroviral therapy (ART), HIV has transitioned from a terminal illness to a chronic condition requiring long-term management. Despite substantial improvements in life expectancy in the modern treatment era, PLWH still face significant medical comorbidities and threats to their health-related quality of life. HIV appears to sensitize the peripheral nervous system and facilitate sensitivity to a painful stimulus. A growing body of evidence derived from animal models has shown a specific biological basis linking HIV to pain sensitivity. HIV is likely not the only factor contributing to greater pain sensitivity; there are also important psychosocial factors like pain catastrophizing and social stigma related to HIV status. Pain catastrophizing is a negative emotional and cognitive response to actual or anticipated pain. It is common for individuals with HIV to be subjected to stigma due to their health status and other lifestyle factors. Studies have shown that significant relationships between pain catastrophizing and stigma and poor health outcomes. This study seeks to determine whether self-repots of internalized, anticipated, and enacted HIV stigma are related to increased pain sensitivity and excessive catastrophic thoughts about pain in PLWH. To investigate differences in experimental pain sensitivity, the researchers enrolled 50 individuals with HIV from the 1917 Clinic in downtown Birmingham as well as 50 controls without HIV from the surrounding community. Results showed that PLWH were generally more pain sensitive than controls, and that heightened pain sensitivity in PLWH may have been directly driven by the detectable presence of HIV. PLWH reported significantly greater pain catastrophizing than controls without HIV, suggesting that irrespective of viral load status, PLWH tended to engage in more catastrophic thoughts. There was no evidence for a relationship between HIV- related stigma and measurements of pain sensitivity. Results suggest that HIV may affect faciltatory pain processes but not inhibitory pain processes in PLWH.

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