Treating Comorbid Pain and Depression in HIV+ Individuals (HIVPass)
HIV, Depression, Pain
About this trial
This is an interventional treatment trial for HIV
Eligibility Criteria
Inclusion Criteria:
- Chronic Pain (pain duration for at least six months with a mean score of greater than 3.5 on the BPI Pain Interference Scale)
- Pain severity > or equal to 4 on a Numeric Rating Scale indicating "average pain in the last week"
- At least one trial of PCP-recommended medication (i.e. acetaminophen, NSAIDS, muscle relaxants) judged through interviews with patients and PCPs
- Quick Inventory of Depression Symptoms (QIDS) score of ≥ 9 (depression severity)
- Stable dose of an antidepressant, if using, for the previous 1 months
- Age > or equal to 18
- HIV+
- Planning to live in the area for the next 6 months
- Access to a telephone that is typically working.
Exclusion Criteria:
- In psychotherapy or a multidisciplinary pain management program
- Planned surgery in the next 6 months
- Pain thought due to cancer
- Current mania
- Past year chronic psychotic condition
- Excessive substance use (Use of cocaine, heroin, or non-prescribe opioids 15 days per month or more; binge alcohol use 4 days per month or more)
- Suicidality requiring immediate attention
- Pregnancy or planned pregnancy in the next 6 months
Sites / Locations
- Boston University/Boston Medical Center
- Hennepin Healthcare
- Butler Hospital
- The Miriam Hospital
Arms of the Study
Arm 1
Arm 2
Placebo Comparator
Experimental
Health Education
HIVPASS
The seven sessions will cover: 1) nutrition (2 sessions), 2) sleep hygiene, 3) building immunity (e.g., how to avoid colds/flu), 4) injury/disease prevention (e.g., seat belts, sunscreen, when to get regular check-ups/screenings etc.), 5) benefits of exercise/cardiac health, 6) alternative medicine (massage, acupuncture). These sessions will be primarily didactic and consist of health education, followed by discussion as to how this information compares to that which the participants may have been exposed to in the past.
Over 7 sessions, the interventionist and the participant will explore the relationship between pain, depressive symptoms, and HIV. General information about pain, HIV and depression will be discussed, as will avoidance of physical activity. Psychoeducation about these areas will be tied to the participant's stated life goals, and exposure exercises and goal lists will be developed. Later sessions will integrate continued efforts towards reaching goals and reducing avoidance. A release of information will be obtained from the participant to allow study session chart notes to be placed in the medical record at the participant's PCP office and to allow the PCP and the study interventionist to discuss treatment coordination.