Abstract
BackgroundManaging HIV infection as a chronic condition includes encouraging adoption of healthy behaviors and promotion of physical activity (PA). However, people living with HIV (PLH) are often under social and programmatic vulnerability that may compromise behavior change. Understanding such barriers is crucial for successful incorporation of PA in their comprehensive care.Methods and findingsIn this study, we describe PA, energy intake from diet, and anthropometry of a cohort of PLH starting antiretroviral therapy (ART) at a Brazilian reference clinic, report how PA was addressed in routine care and investigate association between PA, energy intake and psychosocial constructs that may facilitate PA (social support and self-efficacy for PA). Among 61 PLH (86.9% males, mean age = 32.5 years) anthropometry was normal, but 47.5% reported PA below recommendations. Despite presenting high social support scores, family encouragement for PA was low, and self-efficacy classified as medium. Chart reviews yielded infrequent reports concerning PA. After adjusting for gender and age, we found a negative association between energy intake from diet and self-efficacy, but none between PA and energy intake or between PA and psychosocial constructs.ConclusionsWe conclude that patients in our cohort were insufficiently active when starting ART, and that PA was poorly addressed by caretakers in routine HIV care. Nevertheless, social support and self-efficacy scores suggest potential for behavioral change. Caregivers should therefore start considering patients’ vulnerabilities and establishing strategies to help them overcome barriers to incorporate PA in their comprehensive care effectively.
Highlights
Combined antiretroviral therapy has remarkably reduced AIDS-related morbidity and mortality and enabled HIV infection to be managed as a chronic disease [1,2,3]
We describe physical activity (PA), energy intake from diet, and anthropometry of a cohort of people living with HIV (PLH) starting antiretroviral therapy (ART) at a Brazilian reference clinic, report how PA was addressed in routine care and investigate association between PA, energy intake and psychosocial constructs that may facilitate PA
We conclude that patients in our cohort were insufficiently active when starting ART, and that PA was poorly addressed by caretakers in routine HIV care
Summary
Combined antiretroviral therapy has remarkably reduced AIDS-related morbidity and mortality and enabled HIV infection to be managed as a chronic disease [1,2,3] In this prolonged survival scenario people living with HIV (PLH) need to cope with long-term outcomes of chronic HIV infection, including lipodystrophy, diabetes and consequent increased cardiovascular risk [4]. Recent data show that the city is ranked last among Brazilian state capitals in general population engagement in PA, with only 34.6% of its residents reporting practicing exercise for more than 150 minutes weekly in their leisure time [16] Given their high social vulnerability, PLH are expected to have even more difficulties in adopting healthier lifestyles that include PA. Understanding such barriers is crucial for successful incorporation of PA in their comprehensive care
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