Among sedentary PLHIV at high risk of cardiovascular disease, the SystemCHANGE intervention reduced daily carbohydrate intake and body weight, but did not increase physical activity or improve overall diet quality. Future work should identify fundamental personal, interpersonal, and contextual factors that will increase physical activity and improve overall diet quality among this population, and integrate these factors into tailored, lifestyle interventions for aging PLHIV.

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Background: People living with HIV (PLHIV) are at elevated risk of developing atherosclerotic cardiovascular disease (ASCVD). PLHIV do not engage in recommended levels of ASCVD prevention behaviors, perhaps due to a reduced perception of risk for ASCVD. We examined how HIV status influences knowledge, beliefs, and perception of risk for ASCVD and ASCVD prevention behaviors. Methods and Results: We conducted a mixed-methods study of 191 PLHIV and demographically similar HIV-uninfected adults. Participants completed self-reported surveys on CVD risk perceptions, adherence to CVD medication (aspirin, antihypertensives, and lipid-lowering medication) and 3 dietary intake interviews. All wore an accelerometer to measure physical activity. A subset of PLHIV (n = 38) also completed qualitative focus groups to further examine the influence of HIV on knowledge, perception of risk for ASCVD, and behavior. Participants: They were approximately 54 (±10) years, mostly men (n = 111; 58%), and African American (n = 151, 83%) with an average 10-year risk of an ASCVD event of 10.4 (±8.2)%. PLHIV were less likely to engage in physical activity (44% vs 65%, P < 0.05), and HIV status was associated with 43 fewer minutes of physical activity per week (P = 0.004). Adherence to ASCVD medications was better among PLHIV (P < 0.001). Diet composition was similar between groups (P > 0.05). HIV status did not influence ASCVD risk perceptions (P > 0.05) and modestly influenced physical activity and smoking. Conclusions: Although perceptions of ASCVD risk modestly influence some behaviors, additional barriers and insufficient cues to action result in suboptimal physical activity, dietary intake, and smoking rates. However, PLHIV have high adherence to ASCVD medications, which can be harnessed to reduce their high burden of ASCVD.

Aim: (1) describe the percentage of people living with HIV (PLWH) experiencing high levels of treatment burden who are at risk for self-management non-adherence, and (2) examine the relationship between known antecedent correlates (the number of chronic conditions, social capital, and age) of self-management and treatment burden while controlling for sample socio-demographics. Background: Chronic condition self-management is key to maintaining optimal health in the aging population of PLWH. Despite the efforts of providers, patients, and caregivers, self-management non-adherence is still a factor contributing to poor chronic condition self-management and subsequent poor health outcomes. Recent research has identified treatment burden as a risk factor of poor chronic disease self-management adherence. Method: Cross-sectional, secondary analysis of a sub-sample of 103 community dwelling, men and women diagnosed with HIV/AIDS derived from a larger parent study examining physical activity patterns in PLWH. Results: Participants reported an overall low level of treatment burden (M = 22.84; SD = 24.57), although 16% (n = 16) of the sample indicated experiencing high treatment burden. The number of chronic conditions (r = 0.25; p ≤ .01) and social capital (r = −0.19; p = .03) were significantly correlated with treatment burden. Multivariate analysis testing known antecedent correlates of treatment burden was statistically significant (p < .05), but only explained 8% of treatment burden’s variance. Conclusion: Findings have implications for nursing care of PLWH demonstrating a subset of PLWH experience high treatment burden related to chronic condition self-management. Findings also identify characteristics of PLWH who may be at high risk for treatment burden and subsequent self-management non-adherence.

Accessible summaryWhat is known on the subject? Depression affects 1 in 20 Americans, and people living with HIV experience depression at 2–3 times the rate of the general population. Recent research has shown that a person's level of social connectedness (e.g., social networks) is important to understanding their health and ability to get help when they need it. The scientific rationale of this work is to determine whether there is a direct relationship between levels of depression and a measure of social connectedness in people with HIV who are at higher than normal risk of depression and depressive symptoms. What this paper adds to existing knowledge? We examined the relationship between levels of depression and social capital in people living with HIV to determine whether depression may influence their beliefs about their social connectedness and available resources. We found that as depression increases, self‐reported social capital decreases, suggesting that people living with HIV who are depressed may feel less socially connected and/or not be confident they can access resources when they need them. What are the implications for practice Mental health nurses are particularly well‐positioned to help people living with HIV who are living with depression by helping them build skills for building and maintaining relationships, adhering to co‐administered HIV and mental health medical treatments, and helping these individuals to identify and address barriers to social connectedness. Helping people living with HIV to address depression and promoting social connectedness can not only improve quality of life, but have major long‐term health benefits. AbstractIntroductionPeople living with HIV (PLWH) are disproportionately burdened by depression, with estimates as high as 80% of PLWH reporting depressive symptoms. Depression in PLWH is complex, and has been linked with biological and psychosocial causes, including low social capital. Few studies have examined the relationship between social capital and depression in PLWH.Aim/QuestionWe conducted a secondary analysis of the relationship between social capital (Social Capital Scale score) and depression (Beck Depression Inventory‐II scores) to determine whether depression predicted levels of social capital in a sample of 108 PLWH.ResultsDepression was significantly associated with lower social capital r(105) = −.465 p < .001. Depression remained a significant predictor of social capital in the linear regression model, F(5,101) = 8.508, p < .000, R2 = 0.296, when controlling for age and education level.DiscussionOur results suggest that depression may be a significant predictor of low social capital, and these factors may have cyclical relationships that explain persistent depression in this population.Implications for practiceMental health nurses are particularly well‐positioned to help PLWH who are living with depression by helping them build skills for building and maintaining relationships, adhering to co‐administered HIV and mental health medical treatments, and helping these individuals to identify and address barriers to social connectedness.