Associations between pain, mobility, quality of life and mental health in people of Black ethnicities with HIV in London

BACKGROUND: Chronic pain, and its relationship with physical function and mental health, remains under-explored in people of Black ethnicities with HIV who experience intersecting inequities which may affect the experience and impact of pain. We investigated associations between severity of pain, physical function and mental health in these populations. SETTING: Three HIV clinics in South London, UK. METHODS: We conducted a cross-sectional study in adults of Black ethnicities with HIV. Multivariable logistic regression analysis was used to examine associations between mild and moderate-severe pain, physical function and mental health. RESULTS: We enrolled 398 participants (median age 52 years, 55% female); 16% reported mild pain and 25% moderate-severe pain. In multivariable analysis, moderate-severe pain (vs. no pain) was associated with moderate-severely impaired mobility (adjusted odds ratio [aOR] 72.6 [25.7, 250]), moderate-severely impaired ability to self-care (aOR 16.4 [4.1, 111]), moderate-severely impaired ability to perform usual activities (aOR 14.9 [6.3, 37.4]), and poor mental health (aOR 9.2 [5.1, 17.1]), and mild pain with mild and moderate-severe impairment of mobility (aOR 6.5 [2.5, 17.8] and 5.2 [1.5, 18.8] respectively), mild impairment in the ability to perform usual activities (aOR 4.8 [1.9, 11.9), and poor mental health (aOR 2.4 [1.2, 4.8]). CONCLUSION: In this sample of people of Black ethnicities with HIV, two-fifths reported pain. Pain, regardless of severity, was associated with mobility impairment, difficulties performing activities of daily living, and poor mental health. We recommend evaluation of pain in HIV clinical services and establishing robust pain management pathways to maximise quality of life.