Living with HIV often means living with chronic pain, but behavioral therapy could offer an effective alternative to opioids.
The National Institutes of Health (NIH) has awarded a five-year grant totaling more than $3 million to Jessica Merlin, M.D., Ph.D., M.B.A., visiting associate professor of internal medicine and infectious disease at the University of Pittsburgh Department of Medicine, for the first full-scale trial of behavioral therapy for chronic pain among people living with HIV.
"There aren't a lot of treatments that work very well for chronic pain in the general population, and there is very little that has been tailored to patients with HIV," said Merlin. "When trying to use behavioral interventions to improve health, it's important to consider the unique needs of the patient population."
Often, people with HIV not only have to shoulder the burden of chronic pain, Merlin added, but also social stigma, isolation and mental health issues.
In pilot research for this new grant, Merlin asked people living with HIV and their doctors about what they wanted in a pain management program, and two major themes emerged: peer-led group sessions and sponsorship - similar to the Alcoholics Anonymous model. She incorporated this feedback into a new program called Skills TO Manage Pain (STOMP).
Inspiration for this project came more than a decade earlier when Merlin, a medical student at that time, was caring for patients with HIV in Botswana.
"The psychosocial aspects of HIV and the pain burden that I was seeing were really striking," Merlin said. "I realized I didn't have the appropriate tools to manage those things."