Auricular Vagus Nerve Stimulation Mechanisms for HIV-Associated Peripheral Neuropathy

Inclusion Criteria: * Established HIV infection * Glove/stocking dysesthesias lasting for ≥3 months * HIV-associated peripheral neuropathy (HIV-PN) related symptoms ≥4 (on a scale of 0-10) within the last week * Stable medical care (i.e., no changes in Antiretroviral Therapy or pain medication within 2 months of enrollment) * Able to read the consent form, demonstrate understanding of study procedures and requirements, and independently provide written informed consent Exclusion Criteria: * Unstable cardiac disease * Implanted electronic or magnetic devices (e.g., pacemaker, cochlear implants, medication pumps, and other implanted neurostimulation systems) * Head or neck cancer or metastases * Recent ear trauma or metal implants in the head * History of epilepsy, unprovoked seizure, stroke, brain tumor, significant traumatic brain injury, prior intracranial surgery, or other neurological condition associated with increased seizure risk * Active or uncontrolled comorbidities that independently cause neuropathy (e.g., recent chemotherapy, uncontrolled diabetes with documented neuropathic complications) * Clinical evidence of non-HIV neuropathy (e.g., neuropathic symptoms predating HIV diagnosis, uncontrolled diabetes) * Known allergy to tape/adhesive * Ferromagnetic or non-MRI-compatible metal in the head, neck, eye, or cranial region, including aneurysm clips, retained metal fragments, bullets, shrapnel, or other metallic implants not demonstrated to be TMS-compatible. * Pregnancy or actively breast feeding