Evidence map›Paper›PMID 41448689›Full record

ArticleBMJ open2025

Experiences and impact of chronic pain in South Africans living in a rural area: a qualitative study.

Mamakiri Mulaudzi, Andani Ratshinanga, John Mohale, Tebatso Ramoshai, Michael Evangeli, Tamar Pincus, Romy Parker, Chijioke N Umunnakwe, Hugo Tempelman, Antonia Wadley

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Temporal relationships between distress and pain in people living with HIV.medRxiv : the preprint server for health sciences · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mamakiri MulaudziDepartment of Psychology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa.
Andani RatshinangaBrain Function Research Group, Department of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
John MohaleBrain Function Research Group, Department of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Tebatso RamoshaiDepartment of Psychology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa.
Michael EvangeliDepartment of Psychology, Royal Holloway University of London, Egham, UK.
Tamar PincusDepartment of Psychology, University of Southampton, Southampton, UK T.Pincus@soton.ac.uk.
Romy ParkerPain Management Unit, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Rondebosch, South Africa.
Chijioke N UmunnakweNdlovu Research Centre, Ndlovu Care Group, Elandsdoorn, Dennilton, South Africa.
Hugo TempelmanNdlovu Research Centre, Ndlovu Care Group, Elandsdoorn, Dennilton, South Africa.
Antonia WadleyBrain Function Research Group, Department of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID http://orcid.org/0000-0001-5654-0047

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPrevious work in South Africans living with HIV and chronic pain has raised questions regarding maintained levels of physical activity while in pain, patterns of pain disclosure and recruitment of social support. Recent data suggest that pain in people living with HIV may be more due to issues of poverty rather than HIV. We explored how South Africans with chronic pain living in a rural area: (1) understand and experience chronic pain, (2) how chronic pain affects activity levels and (3) the relationship between pain disclosure and social support.

designWe conducted a qualitative study using in-depth interviews. Transcripts were analysed using thematic data analysis.

settingThe Ndlovu Care Group Research Centre in the rural Elandsdoorn, Dennilton area in Limpopo province, South Africa, between April and July 2019.

participants34 individuals (19 women, 15 men) with a mean age of 37 years (SD 8) living with chronic pain, half of whom were living with HIV, and half without.

resultsPerceived causes of pain included illness or injury, 'thinking too much' and non-Western perspectives. Three patterns of activity in response to chronic pain emerged: perseverance, reduced activity and complete inactivity. Reasons for perseverance included fear of losing income, perceived social stigma or no social support. Patterns of pain disclosure included full, selective (telling some people but not others depending on their perceived trustworthiness), partial (sharing pain presence but not how severe it was) and non-disclosure. Disclosing pain was common in women and was used to recruit practical support. Men rarely disclosed to recruit support, and if they did, would recruit for financial support. Disclosing pain was also a strategy to avoid the social stigma of being labelled 'lazy'. Patterns of activity, disclosure and type of support recruited did not differ between those with and without HIV.

conclusionsOur findings suggest that activity levels, disclosure and recruitment of support in South Africans living with chronic pain are influenced by low income, social stigma and gender, rather than HIV.

Indexed as

Chronic PainHIV InfectionsSocial SupportAdultAfrican PeopleExerciseFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchRural PopulationSocial StigmaSouth AfricaAfrica South of the SaharaChronic PainHIV & AIDSSocial Support

Identifiers

PMID41448689
PMCPMC12742062

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.