<s>[INST] Im am HIV positive 4 yrs on trtment but lately I hav a pain at my back on my sholders next to the neck, I dont know what couses that pain as if im carry something heavy with my shoulders...I now relly on pain killers to ease the pain pls help couse im strugling even at work I cant cope anymore due to the pain it is killing me slowly. [/INST] Hi, Welcome to HCM. Pain over shoulder and neck can occur to anybody. It depends upon your age, work and family history. These symptoms can occur also with HIV disease either as bony changes due to HIV disease or due to ART drugs that can decrease bone mineral density. Your treating physician , with  a thorough history and appropriate investigations will able to guide you better in this regards. Wish you a speedy recovery. Dr S.Murugan </s>