{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:10:12Z","timestamp":1792786212811,"version":"4.5.0"},"posted":{"date-parts":[[2025,11,13]]},"group-title":"Public and Global Health","reference-count":79,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"award":["K43TW011442"],"award-info":[{"award-number":["K43TW011442"]}],"id":[{"id":"https:\/\/ror.org\/02xey9a22","id-type":"ROR","asserted-by":"publisher"}]},{"award":["1K43TW012840"],"award-info":[{"award-number":["1K43TW012840"]}],"id":[{"id":"https:\/\/ror.org\/02xey9a22","id-type":"ROR","asserted-by":"publisher"}]},{"name":"National Institute of Neurological Disorders and Stroke","award":["K24 NS126570"],"award-info":[{"award-number":["K24 NS126570"]}],"id":[{"id":"https:\/\/ror.org\/01s5ya894","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Social factors are consequences and determinants of chronic pain, yet little is known about how informal social support operates for people with chronic pain and HIV. The overlapping burdens of emotional distress and chronic pain in people living with HIV raise the need to identify targets for culturally resonant treatments. This qualitative study explored how people living with chronic or recurrent pain and HIV seek informal social support for pain and distress from their social networks, how these networks operate, and how social support is influenced by socio-ecological factors. Adults with virally suppressed HIV who repeatedly reported pain were purposively sampled and interviewed. Semi-structured, individual in-depth interviews (n=18) explored individuals\u2019 experiences of living with HIV and chronic pain, distress and its relationship to pain, and help-seeking behaviours for chronic pain and distress. Codebook thematic analysis was used within an interpretivist epistemological approach. Support for pain involved more tangible actions by fewer people than support for distress. Disruptions in social support were more likely when the person with pain was irritable, socially withdrawn, or unable to fulfil social roles. Interpersonal conflict could also cause or increase pain and distress. Current pain assessments rarely identify the social interference of pain identified here. This work identified potential targets for individual-level interventions to sustain informal social support: individuals\u2019 abilities to cope with daily stressors, pain self-management strategies to facilitate socialisation and engagement in valued life activities, and strategies to prevent support fatigue in informal social networks.<\/jats:p>","DOI":"10.1101\/2025.11.07.25339650","type":"posted-content","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T01:10:58Z","timestamp":1763082658000},"source":"Crossref","is-referenced-by-count":1,"title":["Informal social support for chronic pain and distress in people with HIV: identifying targets for intervention"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5357-4062","authenticated-orcid":false,"given":"Victoria J","family":"Madden","sequence":"first","affiliation":[{"name":"African Pain Research Initiative, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, South Africa"},{"name":"HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6774-4525","authenticated-orcid":false,"given":"Lara","family":"Court","sequence":"additional","affiliation":[{"name":"African Pain Research Initiative, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, South Africa"},{"name":"Division of Social and Behavioural Sciences, School of Public Health, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andiswa","family":"Gidana","sequence":"additional","affiliation":[{"name":"African Pain Research Initiative, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9938-6887","authenticated-orcid":false,"given":"Lucia","family":"Knight","sequence":"additional","affiliation":[{"name":"Division of Social and Behavioural Sciences, School of Public Health, University of Cape Town, South Africa"},{"name":"School of Public Health, University of the Western Cape, Bellville, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5654-0047","authenticated-orcid":false,"given":"Antonia","family":"Wadley","sequence":"additional","affiliation":[{"name":"Brain Function Research Group, Department of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0542-2221","authenticated-orcid":false,"given":"Luyanduthando","family":"Mqadi","sequence":"additional","affiliation":[{"name":"African Pain Research Initiative, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5464-0746","authenticated-orcid":false,"given":"Stephan","family":"Rabie","sequence":"additional","affiliation":[{"name":"HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4873-0443","authenticated-orcid":false,"given":"Robert R","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Joska","sequence":"additional","affiliation":[{"name":"HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4823-2487","authenticated-orcid":false,"given":"Romy","family":"Parker","sequence":"additional","affiliation":[{"name":"African Pain Research Initiative, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026100806550596000_2025.11.07.25339650v3.1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304747"},{"key":"2026100806550596000_2025.11.07.25339650v3.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7."},{"issue":"3","key":"2026100806550596000_2025.11.07.25339650v3.3","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.jpain.2022.10.004","article-title":"Chronic Struggle: An Institutional Ethnography of Chronic Pain and Marginalization","volume":"24","year":"2023","journal-title":"J Pain"},{"issue":"2","key":"2026100806550596000_2025.11.07.25339650v3.4","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.pmn.2014.05.001","article-title":"The influence of chronic pain on the daily lives of underprivileged South Africans","volume":"16","year":"2015","journal-title":"Pain Manag Nurs"},{"issue":"4","key":"2026100806550596000_2025.11.07.25339650v3.5","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1037\/fsh0000069","article-title":"The impact of chronic pain: the perspective of patients, relatives, and caregivers","volume":"32","year":"2014","journal-title":"Fam Syst Health"},{"key":"2026100806550596000_2025.11.07.25339650v3.6","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000293"},{"issue":"2","key":"2026100806550596000_2025.11.07.25339650v3.7","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1097\/j.pain.0000000000002066","article-title":"Intergenerational transmission of chronic pain-related disability: the explanatory effects of depressive symptoms","volume":"162","year":"2021","journal-title":"Pain"},{"key":"2026100806550596000_2025.11.07.25339650v3.8","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-073538"},{"issue":"4","key":"2026100806550596000_2025.11.07.25339650v3.9","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/papr.13103","article-title":"Management of chronic low back pain and the impact on patients\u2019 personal and professional lives: Results from an international patient survey","volume":"22","year":"2022","journal-title":"Pain Pract"},{"issue":"3","key":"2026100806550596000_2025.11.07.25339650v3.10","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s10880-024-10012-w","article-title":"Partners\u2019 Experiences of Chronic Pain: A Qualitative Evidence Synthesis","volume":"31","year":"2024","journal-title":"J Clin Psychol Med Settings"},{"key":"2026100806550596000_2025.11.07.25339650v3.11","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001732"},{"issue":"6","key":"2026100806550596000_2025.11.07.25339650v3.12","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1093\/pm\/pnaa373","article-title":"A Healing Journey with Chronic Pain: A Meta-Ethnography Synthesizing 195 Qualitative Studies","volume":"22","year":"2021","journal-title":"Pain Med"},{"key":"2026100806550596000_2025.11.07.25339650v3.13","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.bbi.2019.08.196","article-title":"Loneliness in healthy young adults predicts inflammatory responsiveness to a mild immune challenge in vivo","volume":"82","year":"2019","journal-title":"Brain, behavior, and immunity"},{"key":"2026100806550596000_2025.11.07.25339650v3.14","first-page":"607","article-title":"Social isolation promotes tumor immune evasion via \u03b22-adrenergic receptor","volume":"123","year":"2024","journal-title":"Brain, behavior, and immunity"},{"key":"2026100806550596000_2025.11.07.25339650v3.15","doi-asserted-by":"publisher","DOI":"10.1037\/a0034012"},{"issue":"11","key":"2026100806550596000_2025.11.07.25339650v3.16","doi-asserted-by":"crossref","first-page":"2102","DOI":"10.1080\/13607863.2023.2219626","article-title":"Serial multiple mediation of loneliness and depressive symptoms in the relationship between pain and cognitive function among older people","volume":"27","year":"2023","journal-title":"Aging Ment Health"},{"key":"2026100806550596000_2025.11.07.25339650v3.17","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000624"},{"key":"2026100806550596000_2025.11.07.25339650v3.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.12.002"},{"issue":"9","key":"2026100806550596000_2025.11.07.25339650v3.19","doi-asserted-by":"crossref","first-page":"T70","DOI":"10.1016\/j.jpain.2016.01.001","article-title":"The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain","volume":"17","year":"2016","journal-title":"The Journal of Pain"},{"key":"2026100806550596000_2025.11.07.25339650v3.20","doi-asserted-by":"publisher","DOI":"10.1007\/BF00922627"},{"key":"2026100806550596000_2025.11.07.25339650v3.21","doi-asserted-by":"publisher","DOI":"10.2307\/2136504"},{"key":"2026100806550596000_2025.11.07.25339650v3.22","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.paid.2014.12.047","article-title":"When is received social support related to perceived support and well-being? When it is needed","volume":"77","year":"2015","journal-title":"Personality and Individual Differences"},{"issue":"12","key":"2026100806550596000_2025.11.07.25339650v3.23","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1097\/j.pain.0000000000001369","article-title":"Psychosocial factors associated with persistent pain in people with HIV: a systematic review with meta-analysis","volume":"159","year":"2018","journal-title":"Pain"},{"issue":"4","key":"2026100806550596000_2025.11.07.25339650v3.24","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/pme.12701","article-title":"Pain self-management in HIV-infected individuals with chronic pain: a qualitative study","volume":"16","year":"2015","journal-title":"Pain Med"},{"issue":"5","key":"2026100806550596000_2025.11.07.25339650v3.25","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1097\/j.pain.0000000000001783","article-title":"A qualitative study of the experience and impact of neuropathic pain in people living with HIV","volume":"161","year":"2020","journal-title":"Pain"},{"key":"2026100806550596000_2025.11.07.25339650v3.26","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.17.1.18719"},{"issue":"8","key":"2026100806550596000_2025.11.07.25339650v3.27","doi-asserted-by":"crossref","first-page":"ofad350","DOI":"10.1093\/ofid\/ofad350","article-title":"Global Prevalence of Chronic Pain in Women with HIV: A Systematic Review and Meta-analysis","volume":"10","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"2026100806550596000_2025.11.07.25339650v3.28","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2020-0004"},{"issue":"5","key":"2026100806550596000_2025.11.07.25339650v3.29","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1007\/s10461-022-03894-0","article-title":"Effect of Social Support Interventions on Adherence to Antiretroviral Therapy Among People Living with HIV: A Systematic Review and Meta-Analysis","volume":"27","year":"2023","journal-title":"AIDS and behavior"},{"issue":"8","key":"2026100806550596000_2025.11.07.25339650v3.30","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1080\/09540121.2021.1902936","article-title":"The Global Task Force for Chronic Pain in People with HIV (PWH): Developing a research agenda in an emerging field","volume":"35","year":"2023","journal-title":"AIDS care"},{"key":"2026100806550596000_2025.11.07.25339650v3.31","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001844"},{"key":"2026100806550596000_2025.11.07.25339650v3.32","doi-asserted-by":"crossref","unstructured":"Mulaudzi M , Ratshinanga A , Mohale J , Ramoshai T , Evangeli M , Pincus T , et al. Experiences and impact of chronic pain in South Africans living in a rural area: a qualitative study. medRxiv. 2025:2025.07.22.25331712.","DOI":"10.1101\/2025.07.22.25331712"},{"issue":"12","key":"2026100806550596000_2025.11.07.25339650v3.33","doi-asserted-by":"crossref","first-page":"622","DOI":"10.2188\/jea.JE20150263","article-title":"Informal and Formal Social Support and Caregiver Burden: The AGES Caregiver Survey","volume":"26","year":"2016","journal-title":"J Epidemiol"},{"key":"2026100806550596000_2025.11.07.25339650v3.34","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(00)00065-4"},{"key":"2026100806550596000_2025.11.07.25339650v3.35","first-page":"847","volume-title":"Introduction to health psychology","volume":"158","year":"2003"},{"issue":"2","key":"2026100806550596000_2025.11.07.25339650v3.36","first-page":"535","article-title":"Social support","volume":"3","year":"1998","journal-title":"Encyclopedia of mental health"},{"issue":"1","key":"2026100806550596000_2025.11.07.25339650v3.37","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s10461-019-02451-6","article-title":"Using a Social Support Framework to Understand How HIV Positive Kenyan Men Engage in PMTCT\/EID Care: Qualitative Insights From Male Partners","volume":"24","year":"2020","journal-title":"AIDS and behavior"},{"key":"2026100806550596000_2025.11.07.25339650v3.38","doi-asserted-by":"crossref","unstructured":"Drageset J. Social Support. In: Haugan G , Eriksson M , editors. Health Promotion in Health Care \u2013 Vital Theories and Research. Cham: Springer; 2021. p. 137\u201344.","DOI":"10.1007\/978-3-030-63135-2_11"},{"key":"2026100806550596000_2025.11.07.25339650v3.39","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.1997.1997025095.x"},{"key":"2026100806550596000_2025.11.07.25339650v3.40","doi-asserted-by":"crossref","unstructured":"Madden VJ , Msolo N , Mqadi L , Lesosky M , Bedwell GJ , Hutchinson MR , et al. Study protocol: an observational study of distress, immune function and persistent pain in HIV. BMJ open. 2022;12(6).","DOI":"10.1136\/bmjopen-2021-059723"},{"key":"2026100806550596000_2025.11.07.25339650v3.41","doi-asserted-by":"crossref","unstructured":"Madden VJ , Mqadi L , Arendse G , Bedwell GJ , Msolo N , Lesosky M , et al. Provoked cytokine response is not associated with distress or induced secondary hyperalgesia in people with suppressed HIV. Pain. 2025.","DOI":"10.1101\/2025.01.21.25320673"},{"key":"2026100806550596000_2025.11.07.25339650v3.42","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"2026100806550596000_2025.11.07.25339650v3.43","unstructured":"Statistics South Africa. South African National Census of 2011. Pretoria, South Africa: Stats SA; 2012."},{"key":"2026100806550596000_2025.11.07.25339650v3.44","unstructured":"Woldesenbet SA , Lombard C , Manda S , Kufa T , Ayalew K , M. C, et al. The 2019 National Antenatal HIV Sentinel Survey. South Africa: National Department of Health; 2021."},{"key":"2026100806550596000_2025.11.07.25339650v3.45","unstructured":"Naomi model. South Africa District HIV Estimates, December 2024 [Available from: https:\/\/www.hivdata.org.za."},{"key":"2026100806550596000_2025.11.07.25339650v3.46","doi-asserted-by":"publisher","DOI":"10.1037\/qup0000196"},{"key":"2026100806550596000_2025.11.07.25339650v3.47","doi-asserted-by":"publisher","DOI":"10.1080\/26895269.2022.2129597"},{"key":"2026100806550596000_2025.11.07.25339650v3.48","doi-asserted-by":"crossref","unstructured":"Brooks J , King N. Doing Template Analysis: Evaluating an End of Life Care Service. Sage Research Methods Cases Part 1: SAGE Publications Ltd.; 2014.","DOI":"10.4135\/978144627305013512755"},{"key":"2026100806550596000_2025.11.07.25339650v3.49","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-017-0632-2"},{"key":"2026100806550596000_2025.11.07.25339650v3.50","unstructured":"Langford CP , Bowsher J Fau - Maloney JP , Maloney Jp Fau - Lillis PP , Lillis PP. Social support: a conceptual analysis. (0309-2402 (Print))."},{"key":"2026100806550596000_2025.11.07.25339650v3.51","doi-asserted-by":"crossref","unstructured":"Braun V , Clarke V . Thematic Analysis: A Practical Guide. London, UK: Sage Publications; 2021.","DOI":"10.4135\/9781036232078.n9"},{"key":"2026100806550596000_2025.11.07.25339650v3.52","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917733847"},{"key":"2026100806550596000_2025.11.07.25339650v3.53","unstructured":"Green J , Thorogood N. Analysing qualitative data. Qualitative Methods for Health Research: Sage."},{"key":"2026100806550596000_2025.11.07.25339650v3.54","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"2026100806550596000_2025.11.07.25339650v3.55","unstructured":"Maluleke R. StatsSA Income & Expenditure Survey 2022\/2023. Statistics South Africa; 2023."},{"issue":"8","key":"2026100806550596000_2025.11.07.25339650v3.56","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1080\/09540121.2020.1869148","article-title":"\"I have failed to separate my HIV from this pain\": the challenge of managing chronic pain among people with HIV","volume":"35","year":"2023","journal-title":"AIDS care"},{"issue":"10","key":"2026100806550596000_2025.11.07.25339650v3.57","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1080\/09540121.2016.1168916","article-title":"The role of chronic pain and current substance use in predicting negative social support among disadvantaged persons living with HIV\/AIDS","volume":"28","year":"2016","journal-title":"AIDS care"},{"key":"2026100806550596000_2025.11.07.25339650v3.58","doi-asserted-by":"crossref","unstructured":"Scott W , Buchman DZ , VasiIiou VS . The multi-dimensional stigma of chronic pain: A narrative review. Curr Opin Psychol. 2025;62:101980.","DOI":"10.1016\/j.copsyc.2024.101980"},{"key":"2026100806550596000_2025.11.07.25339650v3.59","doi-asserted-by":"crossref","unstructured":"Davies RL , Rice K , Rock AJ . The Potential Burden of Informal Support: Exploring Wellbeing and Self-Care of Social Network Members of Intimate Partner Violence Survivors. Journal of Family Violence. 2025.","DOI":"10.1007\/s10896-025-00824-1"},{"issue":"9","key":"2026100806550596000_2025.11.07.25339650v3.60","doi-asserted-by":"crossref","first-page":"104525","DOI":"10.1016\/j.jpain.2024.104525","article-title":"Examining the Role of Structural and Functional Social Network Characteristics in the Context of Chronic Pain: An Ego-centered Network Design","volume":"25","year":"2024","journal-title":"J Pain"},{"key":"2026100806550596000_2025.11.07.25339650v3.61","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3182662215"},{"issue":"8","key":"2026100806550596000_2025.11.07.25339650v3.62","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1080\/09540121.2021.1887445","article-title":"Prevalence of pain in women living with HIV aged 45-60: associated factors and impact on patient-reported outcomes","volume":"35","year":"2023","journal-title":"AIDS care"},{"key":"2026100806550596000_2025.11.07.25339650v3.63","doi-asserted-by":"publisher","DOI":"10.1037\/a0022025"},{"key":"2026100806550596000_2025.11.07.25339650v3.64","doi-asserted-by":"publisher","DOI":"10.1037\/fsh0000459"},{"key":"2026100806550596000_2025.11.07.25339650v3.65","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532-2149.2011.00031.x"},{"key":"2026100806550596000_2025.11.07.25339650v3.66","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.2464"},{"key":"2026100806550596000_2025.11.07.25339650v3.67","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000637"},{"key":"2026100806550596000_2025.11.07.25339650v3.68","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0111765"},{"issue":"4","key":"2026100806550596000_2025.11.07.25339650v3.69","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1177\/10748407231156454","article-title":"Protective Buffering: Nurses Facilitating Communication Between Adults With Cancer and Their Adult Family Caregivers Who Overprotect One Another-An Integrative Review","volume":"29","year":"2023","journal-title":"J Fam Nurs"},{"issue":"3","key":"2026100806550596000_2025.11.07.25339650v3.70","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1023\/B:AIBE.0000044075.12845.75","article-title":"The clinical significance of change in trauma-related symptoms following a pilot group intervention for coping with HIV-AIDS and childhood sexual trauma","volume":"8","year":"2004","journal-title":"AIDS and behavior"},{"key":"2026100806550596000_2025.11.07.25339650v3.71","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19102"},{"issue":"9","key":"2026100806550596000_2025.11.07.25339650v3.72","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/NMD.0000000000000506","article-title":"Managing Pain in Women Living With HIV\/AIDS: A Randomized Controlled Trial Testing the Effect of a Six-Week Peer-Led Exercise and Education Intervention","volume":"204","year":"2016","journal-title":"J Nerv Ment Dis"},{"issue":"1","key":"2026100806550596000_2025.11.07.25339650v3.73","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1186\/s12891-022-05467-7","article-title":"\u201cSo, you must understand that that group changed everything\u201d: perspectives on a telehealth group intervention for individuals with chronic pain","volume":"23","year":"2022","journal-title":"BMC Musculoskeletal Disorders"},{"issue":"3","key":"2026100806550596000_2025.11.07.25339650v3.74","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s10880-022-09901-9","article-title":"Introversion, Extraversion, and Worsening of Chronic Pain Impact during Social Isolation: A Mediation Analysis","volume":"30","year":"2023","journal-title":"J Clin Psychol Med Settings"},{"key":"2026100806550596000_2025.11.07.25339650v3.75","first-page":"2022","article-title":"Quarterly Labour Force Survey","volume":"3","author":"Statistics South Africa","year":"2022","journal-title":"Quarter"},{"key":"2026100806550596000_2025.11.07.25339650v3.76","unstructured":"Statistics South Africa. Quarterly Labour Force Survey Q1:2020. 2020 2020. Contract No.: P0211."},{"key":"2026100806550596000_2025.11.07.25339650v3.77","unstructured":"Nwosu C , Kollamparambil U , Oyenubi A . Socioeconomic inequalities in ability to work from home during the coronavirus pandemic: The case of South Africa. National Income Dynamics Study; 2021."},{"issue":"5","key":"2026100806550596000_2025.11.07.25339650v3.78","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1080\/0376835X.2022.2036105","article-title":"The gendered effects of the Covid-19 crisis in South Africa: Evidence from NIDS-CRAM waves 1\u20135","volume":"39","year":"2022","journal-title":"Development Southern Africa"},{"issue":"3","key":"2026100806550596000_2025.11.07.25339650v3.79","doi-asserted-by":"crossref","first-page":"e0249352","DOI":"10.1371\/journal.pone.0249352","article-title":"Job loss and mental health during the COVID-19 lockdown: Evidence from South Africa","volume":"16","year":"2021","journal-title":"PLoS One"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.11.07.25339650","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:55:22Z","timestamp":1791467722000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.11.07.25339650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,13]]},"references-count":79,"URL":"https:\/\/doi.org\/10.1101\/2025.11.07.25339650","relation":{},"subject":[],"published":{"date-parts":[[2025,11,13]]},"subtype":"preprint"}}