Auricular Point Acupressure for Pain

hronic musculoskeletal pain is common among older people living with HIV and can negatively affect mobility, independence, sleep, and quality of life. Although medications are commonly used to manage chronic pain, older adults living with HIV may already take multiple medications for HIV and other health conditions, increasing concerns about medication burden, side effects, and drug interactions. Accessible, low-cost, non-drug approaches to pain management are therefore needed for this population. This pilot randomized controlled trial will evaluate auricular point acupressure (APA) as a non-invasive approach for managing chronic musculoskeletal pain among adults age 50 years and older who are living with HIV. APA involves placing small seeds on specific points of the outer ear using adhesive tape. Participants apply pressure to these seeds themselves. Unlike acupuncture, APA does not involve needles and can be largely self-administered. The study will enroll 30 participants with chronic musculoskeletal pain and randomly assign them to one of two groups. One group will receive true APA, with seeds placed on ear points designated for chronic musculoskeletal pain. The other group will receive sham APA, with seeds placed on ear points not associated with the painful areas. Both groups will follow the same treatment schedule for four weeks. During the four-week intervention, participants will attend weekly visits for placement of the ear seeds. They will be instructed to press the seeds for three minutes, three times each day. The seeds will remain on the ears for five days, followed by two days without the seeds before the next weekly placement. Participants will also complete daily electronic surveys about their pain and pain medication use and use an under-mattress sleep sensor to measure sleep. Study assessments will be conducted at baseline and at the end of the four-week intervention. The study will examine whether APA shows preliminary benefits for reducing pain and improving sleep and health-related quality of life. It will also evaluate whether APA is feasible, acceptable, and safe for older people living with HIV. Feasibility will be assessed through measures such as recruitment, adherence to the study protocol, and adverse events. At the end of the intervention, participants will complete an individual interview to share their experiences and perceptions of APA. Because this is a small pilot study, its purpose is to provide preliminary information rather than definitive evidence about the effectiveness of APA. The findings will help determine the feasibility of conducting a larger clinical trial and provide preliminary information about APA's potential as an accessible, non-drug approach to chronic pain management for older people living with HIV.