AIDS and Behavior

, Volume 22, Issue 6, pp 2002–2007 | Cite as

Chronic Pain Predicting Reciprocity of Support Among Vulnerable, Predominantly African-American Persons Living with HIV/AIDS

  • Mary M. Mitchell
  • Sarina R. Isenberg
  • Allysha C. Maragh-Bass
  • Amy R. Knowlton
Original Paper


Among persons living with HIV/AIDS (PLHIV), approximately two-thirds report moderate to severe pain. Chronic pain can negatively affect PLHIVs’ health behaviors and outcomes by interfering with their reciprocity (mutual exchange) of support in their caregiving relationships, which has been found to be associated with PLHIVs’ antiretroviral adherence and viral suppression. Data were longitudinal (baseline, 6- and 12-month follow-up) from 383 PLHIV who were formerly or currently using drugs. Utilizing a longitudinal lagged fixed effects structural equation model, we found that never having pain in the past 6 months was predictive of increased reciprocity of support. Sub-analyses by care relationship type revealed never having pain was a significant predictor of greater reciprocity for sexual partner caregiving dyads, but not for kin or friend caregiving dyads. Our study emphasizes the importance of pain management in quality caregiving relationships characterized by reciprocity, which has consistently been found to be associated with stronger, more supportive caregiving relationships and better quality of life. Our findings suggest the importance of pain management intervention for improving reciprocity between vulnerable PLHIVs and their primary caregivers, especially between PLHIVs and caregivers who are current or former sexual partners.


HIV/AIDS African-American Chronic pain Reciprocity of social support Informal caregiving 



The study was supported by Grants R01 DA019413 and R01NR014050, and the Johns Hopkins Center for AIDS Research Grant 1P30 AI094189 from the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

The auhtors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Mary M. Mitchell
    • 1
  • Sarina R. Isenberg
    • 1
  • Allysha C. Maragh-Bass
    • 1
  • Amy R. Knowlton
    • 1
  1. 1.Department of Health, Behavior and SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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