pyAudio and PJSIP in a Virtual Machine
Alright, this isn't the most reliable solution but it does seem to work. 
To start with you must verify you have pulseaudio installed and working
Use what ever package installer you need:
apt-get/yum/zypper pulseaudio pulseaudio-devel alsa-lib alsa-devel alsa-plugins-pulseaudio
pulseaudio --start
pacmd load-module module-null-sink sink_name=MySink
pacmd update-sink-proplist MySink device.description=MySink
This will allow you to pass audio around in your vm so that it can be sent out using pjsip. 
If you dont have your own loopback written in python you can use:
pacmd load-module module-loopback sink=MySink
to pass audio back out. If you do have a loopback written you cannot use both.
I am writing a SIP client in python. I am able to make my script run on my computer just fine. It plays a wav file, grabs the audio and then sends the audio out using a sip session. I am having a very hard time getting this to run in the AWS ec2 VM. The VM is running SUSE 12. 
There seems to be a lot of questions related to audio loop backs and piping audio around. But I haven't found any that seem to encompass all of the ways I am having issues.
I have tried figuring out how to set one up using pacmd but havent had and luck. I have Dummy Output and Monitor of Dummy Output as defaults but that didnt work. 
When I try to open the stream i still get a no default output device error.
What I am trying to find is a way to have a virtual sound card (i guess) that I can have for channels on the sip call and stream the wav file into. 
Any advice or direction would be very helpful.
Thanks in advance