Management of HIV and AIDS Related Chronic Pain in a Primary Care Setting

Sunday, November 1, 2009

Susan C. Wright, D, Tech, Nursing
Mogalagadi R. Makua, B, Tech, Nursing
Johanna E. Maree, D, Cur, (Pret)
Adelaide Tambo School of Nursing Science, Tshwane University of Technology, Pretoria, South Africa

Learning Objective 1: understand the importance of assessing chronic pain in stage 3 and 4 HIV and AIDS patients.

Learning Objective 2: understand the principles of chronic pain assessment criteria and use the World Health Organization approach to alleviate chronic pain in HIV and AIDS patients.

Though the experience of living with HIV and AIDS is unique to each individual, a common factor is dealing with the chronic pain associated with the condition. HIV and AIDS patients may experience pain in more than one area simultaneously; the pain may be caused by the disease itself or the therapies used to treat the disease. The most frequent reason for HIV and AIDS patients seeking health care in a primary health care clinic is pain. The purpose of this study was to determine the effectiveness of chronic pain management for HIV and AIDS patients in a primary health care clinic in Tshwane District. The design was a quantitative survey with a qualitative exploratory component. The data-gathering method was self-report using a semi-structured interview format and observation using a checklist. Data analysis was done with descriptive statistics and content analysis using open coding. The study revealed that patients’ pain was not effectively assessed, though more than 95% of the AIDS patients using the primary health clinic experienced moderate to severe pain. In addition it was determined, using the three-step approach of the World Health Organization as the standard, that the chronic pain of AIDS patients was under-assessed and under-treated in the primary health clinic. Only 8.4% of the prescribing was done according to the guidelines. Under treatment was associated with both the registered professional nurses and the system used in primary health care. A thorough review of the management of HIV and AIDS related chronic pain in primary health care in South Africa is recommended.