Incorporating physical activity in the comprehensive care of people living with HIV starting antiretroviral therapy: Insights from a specialized care setting in Sao Paulo, Brazil

Author(s)

Santos, Ardiles Vitor ^[1] ; Santos, Elisabete Cristina Morandi ^[1] ; Picone, Camila Melo ^[1] ; Dias, Tulio Gamio ^[2] ; Ribeiro, Sandra Maria Lima ^{[3, 4]} ; Florindo, Alex Antonio ^[4] ; Segurado, Aluisio Cotrim ^[1]

Affiliation

^[1] Univ Sao Paulo, Hosp Clin, Fac Med, Dept Div Infect Dis, BR-05508 Sao Paulo - Brazil

^[2] Prefeitura Municipal Joinville, Santa Catarina - Brazil

^[3] Univ Sao Paulo, Fac Saude Publ, BR-05508 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Escola Cienc Artes & Humanidades, BR-05508 Sao Paulo - Brazil

• Document type: Journal article
• Source: PLoS One; v. 16, n. 7 2021.
• Web of Science Citations: 0

Abstract

Background Managing 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 findings In 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. Conclusions 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. 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. (AU)

• FAPESP's process: 13/20249-3 - Evaluation of the effect of physical activity in the primary prevention of body changes and blood carbohydrate and lipid biochemistry, and on inflammatory markers, vascular function and QOL of PLWHA under highly active antiretroviral therapy
• Grantee: Aluisio Augusto Cotrim Segurado
• Support type: Regular Research Grants