OBJECTIVE:To assess quality of life of people living with HIV/AIDS.
METHODS:Cross-sectional study conducted in an AIDS outpatient service based on consecutive sampling during the second half of the year 2002. There were selected 365 men and women aged 18 years or older who were attended by the infectious disease physician. Sociodemographic and recent drug use variables and data on clinical conditions were obtained using a questionnaire and quality of life was analyzed using WHOQOL-bref.
RESULTS:Scores of the four domains (physical, psychological, social relationships and environment) were very similar. There were statistically signifi cant differences in mean scores for the environment domain according to skin color, with blacks and pardos having lower scores. Women also had the lowest scores for the psychological and environmental domains. Higher income was signifi cantly associated to higher scores in all domains of quality of life, except for the social relationships domain. Subjects with CD4+ cell counts below 200 cells/mm 3 had lower scores for the physical domain. In all domains signifi cantly lower scores were seen for those receiving psychiatric treatment or with an indication for such treatment.CONCLUSIONS: Despite differences in sex, skin color, income, and mental and immunological status, people living with HIV/AIDS have better (physical and psychological) quality of life than other patients but lower quality in social relationships domain. The latter domain could refl ect stigmatization and discrimination associated to the diffi culties of disclosing their HIV status in social settings and for a safe sex life.KEY WORDS: Acquired immunodefi ciency syndrome, psychology. Quality of life. Life style. Socioeconomic factors. Cross-sectional studies.
OBJETIVO: Avaliar o estado nutricional de indivíduos portadores do HIV/AIDS em uso de terapia anti-retroviral de alta potência, segundo sexo e número de linfócitos T CD4.+. MATERIAL E MÉTODOS: Estudo transversal envolvendo 223 indivíduos (171 homens e 52 mulheres) tratados com inibidores de protease, com idade entre 20 e 59 anos, recrutados em um serviço de referência em tratamento de HIV/AIDS do município de São Paulo. Os dados antropométricos utilizados foram peso, estatura e circunferência da cintura (CC). O índice de massa corporal (IMC) foi calculado como a razão entre peso (kg) e estatura ao quadrado (m²), de acordo com o critério de classificação proposto pela Organização Mundial de Saúde. Os pacientes foram divididos em três categorias por número de linfócitos T CD4.+: < 200, 201 - 349 e > 350 (cel/mm³). RESULTADOS: A prevalência de sobrepeso na população foi de 30,5%, e de obesidade abdominal de 12,6%. As mulheres apresentaram prevalência maior de sobrepeso (36,5%) e de obesidade abdominal (32,7%) quando comparadas aos homens (28,7% e 6,4% respectivamente). A prevalência de baixo peso foi maior nas mulheres (7,7%) do que nos homens (2,3%). Ausência de associação significativa entre sobrepeso, obesidade abdominal e número de linfócitos T CD4.+ foi observada tanto nos homens como nas mulheres. CONCLUSÃO: As mulheres apresentaram prevalências maiores de baixo peso, sobrepeso e obesidade abdominal em relação aos homens. A obesidade é o desvio do estado nutricional mais importante, superando a desnutrição, nesta população de indivíduos portadores do HIV/AIDS em uso de terapia anti-retroviral de alta potência.
This study evaluates the validity and reliability of the Baecke questionnaire on habitual physical activity when applied to a population of HIV/AIDS subjects. Validity was determined by comparing measurements for 30 subjects of peak oxygen uptake, peak workload, and energy expenditure with scores for occupational physical activity (OPA), physical exercise in leisure (PEL), leisure and locomotion activities (LLA), and total score (TS). Reliability was determined by testing and retesting 29 subjects at intervals of 15-30 days. Validity was evaluated with the Pearson correlation and reliability analyses were done using the intraclass correlation, paired Student t-test, and Bland-Altman methods. Peak VO2 and peak workload had significant correlation with PEL (r = 0.41; r = 0.43; respectively). Energy expenditure had a significant correlation with OPA (r = 0.64). The intraclass coefficients were 0.70 or more for OPA, PEL and TS. There was no difference in OPA, PEL, LLA and TS between the two evaluations. The Bland-Altman methods showed that there was good agreement between the measurements for all habitual physical activities scores. Results show that the Baecke questionnaire is valid for the evaluation of habitual physical activity among people living with HIV/AIDS.
ObjectiveTo validate different methods for estimating HIV/Aids patients' body fat: total body skinfold thickness, central (trunk) skinfold thickness, peripheral (limb) skinfold thickness, waist circumference (WC) and waist-to-hip ratio (WHR). Dual-energy Xray absorptiometry (DEXA) and computed tomography of the abdomen (CTA) were used as the gold standard. Methods An analysis was done on 15 adult HIV/AIDS patients (10 men and 5 women) who were being treated at the AIDS Clinic at a public university hospital, São Paulo, Brazil. Their total subcutaneous fat (TSF) was estimated from the sum of the thicknesses of the biceps, triceps, subscapular, midaxillary, suprailiac, abdominal and medial calf skinfolds. The central subcutaneous fat (CSF) was estimated by summing the subscapular, axillary, suprailiac and abdominal skinfold measurements. The peripheral subcutaneous fat (PSF) was estimated by summing the biceps, triceps and medial calf skinfold measurements. These were compared with DEXA. The WC, WHR and CSF were compared with CTA. In the statistical analysis, the Pearson correlation coefficient (r) and Mann-Whitney test were utilized. Results There was a correlation between fat mass measured by DEXA and by TSF, CSF and PSF, even after adjusting for age (r≥0.80 for all). WC, WHR and CSF presented correlation with total abdominal fat measured by CTA, even after adjusting for age (r≥0.80 for all).
ConclusionsThe methods for estimating body fat should be chosen according to the type of fat to be evaluated and can be used in research and healthcare services instead of DEXA and CTA for HIV/AIDS patients.
-This narrative review examined documents that show the activity of Physical Education professionals for children and young people living with HIV. Forty documents were analyzed, highlighting the main contributions: 1) Sports / Physical Activity for social inclusion of youth in social vulnerability, reducing discrimination and stigma and development of motor skills; 2) Health, for treatment adherence, sexual and reproductive health, functional assessment, prescription, guidance and supervision of physical exercises; 3) Education, for prevention of infection / re-infection with HIV, education for sexual and reproductive health. These interventions include major initiatives to improve the quality of life and to coping the pandemic of HIV in children and young people.
Santos ECM, Florindo AA, Santos AV, Picone CM, Dias TG, Segurado AC. Multicomponent physical activity program to prevent body changes and metabolic disturbances associated with antiretroviral therapy and improve quality of life of people living with HIV: a pragmatic trial. Clinics (Sao Paulo).
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.
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