The Impact of a Health Promotion Educational Program on Cardiovascular Risk Factors for HIV Infected Women on Antiretroviral Therapy

Samaha Hodges

doi:10.4172/2155-6113.1000224

Abstract

This study investigates the efficacy of a health promotion educational program on improving cardiovascular risk factors of weight, Body Mass Index, and waist to hip ratio in 76 predominately African American HIV-infected women. The health promotion educational program was the control group (that focused on improving self-efficacy for nutrition, exercise, stress reduction and women’s health behaviors) of a NIH-funded study. The majority of participants was overweight, obese, or at high risk based on waist hip ratio at the beginning of the study. There were no statistically significant improvements in body mass index or waist hip ratio from pre intervention to up to 9 months post intervention. There were significant changes in waist hip ratio and body mass index in both directions (improvement and worsened) for a small group of participants. The health promotion program did not affect significant changes in cardiovascular risk and should be revised, lengthened, and refocused on nutrition, diet, exercise, and long term goal commitments to reduce the high risk for cardiovascular disease in this group.

Highlights

Antiretroviral Therapy (ART) has significantly lengthened the lives of HIV-infected persons; with increased life spans, HIV Associated Non-AIDS Conditions (HANA) such as Cardiovascular Disease (CVD) are emerging as significant causes of morbidity
Reports suggest that the increasing rates of CVD in HIV infected persons may have a relationship to traditional risk factors such as longer life-spans, increased smoking rates, a weakened glucose tolerance and resistance to insulin and dyslipidemia
Will there be a significant decrease in the anthropometric measurements (BMI, weight, waist, hip circumference, and Waist-to-Hip Ratio (WHR)) of HIV-infected women on ART after attending the 8 session Health Promotion Program (HPP) from pre-HPP to post intervention follow-up points?. This project is a secondary analysis of data collected from the KHARMA (Keeping Healthy and Active with Risk Reduction and Medication Adherence) Project, a Randomized Controlled Clinical Trial (RCT) that tested the efficacy of a nurse-led motivational group intervention to promote adherence to ART and risk reduction behaviors in HIV-infected women compared to an attention equivalent HPP control group led by nurses and a health educator [5,19]

Summary

Introduction

Antiretroviral Therapy (ART) has significantly lengthened the lives of HIV-infected persons; with increased life spans, HIV Associated Non-AIDS Conditions (HANA) such as Cardiovascular Disease (CVD) are emerging as significant causes of morbidity. Reports suggest that the increasing rates of CVD in HIV infected persons may have a relationship to traditional risk factors such as longer life-spans, increased smoking rates, a weakened glucose tolerance and resistance to insulin and dyslipidemia Other factors such as body composition changes (loss of subcutaneous fat and/or the addition of visceral fat in some HIV positive patients), inflammation, and the direct effects that the virus has on the vasculature in addition to the specific effects of the antiretroviral drugs can be linked to CVD [1]. Having a high waist circumference as an HIV infected person can have an association with having an increased risk for hypertension, type 2 diabetes, dyslipidemia, and CVD in persons with a BMI that falls within a range between 25 and 34.9 kg/m2 In those patients that may fall into the obese category, metabolic complications or changes in waist circumference are useful predictors of changes in risk factors for CVD. Waist circumference may be a better indicator for calculating risk for obesity-related disease in older adults [7]

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Discussion

Conclusion