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Pain and Use of Health Services Among Persons Living with HIV

  • Aram Dobalian
  • Jennie C. I. Tsao
  • Lonnie K. Zeltzer
Chapter

Abstract

Pain is a significant factor in a person’s decision to use health services. Moreover, pain is a particularly important factor in the use of health services among persons living with chronic conditions such as human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). In addition, pain has a far-reaching impact on the health-related quality of life (HRQOL) of persons living with HIV. Nevertheless, the manner in which pain influences an individual to seek out health care remains poorly understood despite the fact that pain is a common experience for both adults and children. This chapter summarizes the role of pain in HIV and begins with a synopsis of epidemiologic studies on the prevalence of pain symptoms with a focus on chronic pain. This is followed by a synthesis of the existing evidence-base of studies of pain and the use of health services using Andersen’s Behavioral Model of Health Services Use and includes discussions of both conventional health services and complementary and alternative medicine (CAM) approaches where such studies exist. In this conceptual framework, pain should be considered a perceived need characteristic since a person assesses his or her own pain. Pain is also currently conceptualized as a multidimensional construct that includes social, psychological, and physiological components. Thus, it is not surprising that pain often co-occurs with other health conditions. This chapter also addresses the role of comorbid psychological disorders and substance abuse in the use of health services among persons experiencing pain. Finally, the chapter describes gaps in existing knowledge regarding the role of pain in the use of health services among persons living with HIV, and makes suggestions regarding future directions for this field.

Keywords

Human Immunodeficiency Virus Chronic Pain Psychological Distress Irritable Bowel Syndrome Health Service Utilization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

Research by the first and second authors is supported in part by R03 DA017026 (PI: Tsao) awarded by the National Institute on Drug Abuse.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Aram Dobalian
    • 1
  • Jennie C. I. Tsao
  • Lonnie K. Zeltzer
  1. 1.HSR&D Center of Excellence for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System; Department of Health ServicesUCLA School of Public HealthLos AngelesUSA

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