Table 3 Reasons provided for ‘Yes’ response to the open-ended questions
‘Do you think management of pain is more complex in HIV-infected patients?’ (n = 42) | ||
1. Chronic pain due to other HIV/AIDS related problems | 9 | 21.4% |
2. Drug dependence/addiction leading to decreased response to routine doses | 5 | 11.9% |
3. Associated psychological issues | 5 | 11.9% |
4. Multisystem involvement/multiple problems | 13 | 30.9% |
5. Immune deficiency | 3 | 7.1% |
6. Decreased pain threshold/need for higher doses | 4 | 9.5% |
7. No clear guidance available to healthcare professionals/decreased awareness | 3 | 7.1% |
‘Do you think pain is under-reported and under-treated in HIV infected people?’ | ||
1. It is considered a stigma in society, due to which HIV/AIDS is itself under-reported, and patients may avoid sharing the agony of their pain | 3 | 11.5 |
2. Patients may be on regular pain killers at home due to longstanding ongoing pain conditions and do not inform about new onset of acute pain | 5 | 19.2% |
3. Failure to enquire specifically about pain by physicians on each visit and duly address it | 7 | 26.9% |
4. Patients often have multiple issues going on and come to hospital with HIV/AIDS related complications rather than for isolated pain management, therefore do not specifically report pain | 8 | 30.8% |
5. Generally pain is under treated in all patients with moderate to severe pain as physicians do not feel comfortable in using opioids; multiple analgesics are given to avoid using high doses of opioids | 3 | 11.5% |