Examining the relationships between pain symptoms and psychosocial functioning among women living with and at risk for human immunodeficiency virus using a cross-sectional psychological network analysis

Abstract

Objective: Pain is prevalent among women living with HIV (WLWH); however, research on pain experience among WLWH in the United States is limited. This study used a network analysis to simultaneously examine the relationships between pain experience and psychosocial functioning among WLWH and human immunodeficiency virus (HIV)-negative women.

Method: A secondary analysis of public data from the Women's Interagency HIV Study, a U.S. longitudinal cohort study of the experiences of WLWH and women at increased risk for HIV (HIV negative), was completed. Data were from Visit 42 in 2015 and included 451 WLWH and 194 HIV-negative women who endorsed experiencing pain in the week prior to the interview. Similar to the sociodemographic characteristics of WLWH in the United States, the majority of women in the sample were racially and/or ethnically minoritized and of low socioeconomic position. Networks were modeled using measures of pain intensity, pain interference, depression symptoms, anxiety/worry symptoms, meaning in life, and emotional support.

Results: Network models for WLWH and HIV-negative women were comparable (ps > .05). Depression symptoms were a central construct (strength = 1.82 and 1.77, respectively) within the networks, and pain interference was associated with psychosocial constructs (ps < .05), while pain intensity was not (ps > .05). Meaning in life and emotional support were not directly associated with pain (ps > .05).

Conclusions: Network findings suggest that reducing depression symptoms may result in improved pain experience and broader positive impact for WLWH and for women at increased risk of HIV. This finding is consistent with research with other pain-focused populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).