Musculoskeletal Pain in People Aging With HIV: A Global Narrative Review

Musculoskeletal (MSK) pain is a chronic age-related condition. People with HIV (PWH) report high rates of chronic pain—with MSK pain reported as the most common source—and joints reported as the most common site. As PWH age, MSK-related pain will likely emerge as a growing clinical and quality of life challenge for patients and providers. This review summarizes what is known about MSK pain in PWH and identifies key knowledge gaps. Many well-established risk factors for MSK pain in clinical populations are even more prevalent in PWH, yet few published studies have focused on MSK pain in PWH. Most do not include well-matched comparisons to determine the direct effect of HIV and antiretroviral therapy. It remains unclear how the complex mix of biopsychosocial factors may accelerate or worsen MSK pain onset, severity, and chronicity and in turn, how best to target safe and effective chronic MSK pain management.