Background Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: what is the extent to which physical exercise training affected, symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of intervention, usual care, or no treatment controls? Method Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I2). Results Thirteen studies met the inclusion criteria with 779 participants (n = 596 participants at study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18–86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2–3 times/week, at 40–60 min/session, and for between 6-24 weeks, and the risk of bias vary from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD = − 0.74, 95% confidence interval (CI) − 1.01, − 0.48, p ≤ 0.0002; I2 = 47%; 5 studies; 205 participants) unlike PAL (SMD = 0.98, 95% CI − 0.25, 2.17, p = 0.11; I2 = 82%; 2 studies; 62 participants) and social participation (SMD = 0.04, 95% CI − 0.65, 0.73, p = 0.91; I2 = 90%; 6 studies; 373 participants). Conclusion Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect PAL and social participation. However, the high heterogeneity in the included studies, implies that adequately powered randomised controlled trials with clinical/methodological similarity are required in future studies. Trail Registration number INPLASY202040048.

Background Mobile text reminder (SMS) system is considered a viable strategy for targeting/facilitating healthy behavioural change including adherence to prescribed physical exercises (PE) and medication (antiretroviral therapy-ART) which should improve the quality of life (Qol) in people living with HIV/AIDS(PLWHA). Thus, the literature was appraised for evidence of SMS effectiveness in improving ART and PE adherence behaviours and QoL in PLWHA. Methods Eight databases–AMED, CINAHL, Cochrane Library, EMBASE, EMCARE, Ovid MEDLINE, PsycINFO, and PubMed-were searched up to December 2020, using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol.This review included only randomised control trials (RCTs) investigating the effectiveness of SMS in improving QoL or PE or ART adherence behaviour or a combination of these variables in PLWHA >18 years. Two independent reviewers determined the eligibility of the studies. Data were extracted and the quality of the study was assessed with the Physiotherapy Evidence Database (PEDro) tool. The primary outcomes were ART and PE adherence behaviours while the secondary outcome was QoL. Result A pooled estimate of effect was not calculated due to the heterogeneity of methods and outcome measures. Therefore, a narrative synthesis of ten studies that met the inclusion criteria (n = 1621 participants at study completion) comprising males/females, aged ≥ 18 years, was done. There was a significant improvement in ART adherence behaviour except in three underpowered studies. Only the SMS interventions that were developed using the Starks 3-steps Adherence model was associated with positive outcome. The only study that evaluated QoL was underpowered and reported no significant change while there were no RCTs on PE. Conclusion Effects of SMS intervention trends towards a significant improvement in ART adherence behaviour in PLWHA. It is plausible that SMS reminders developed using the broader framework of the interpersonal health behaviour theory(ies) may have positive outcome. Nevertheless, the observed heterogeneity in the methods/outcome measures warrants a cautious interpretation of the findings. There is a lack/paucity of RCTs and therefore no evidence in support of the effectiveness of SMS intervention in improving PE adherence and QoL. Registration number NPLASY202060016.

Background: Exercise training may increase physical activity(PA) level, improve social participation and mental health in people living with HIV/AIDS(PLWHA). Thus, a systematic review was conducted to answer the review question: what is the effectiveness of physical exercise training on mental health, physical activity level and social participation in PLWHA? Method: Eight databases namely: PubMed, Emcare, Cochrane Library, Embase, CINAHL, AMED, PsycoINFO and MEDLINE – were systematically searched from 1990 till August 2019. This review includes only studies published in English language, on adults (>18years) and are either on HAART/HAART-naïve; only RCTs that gave exercise intervention and assessed mental health, physical activity level and social participation on HIV/AIDS patients. The primary outcomes were mental health, PA level and social participation, while the secondary outcomes included psychological disorders. Results: Meta-analysis of the five (out of seven) included studies for depression that met the inclusion criteria (n=346 participants) comprising males/females aged≥18 years, show a significant overall effect (SMD=-0.89,[95%CI:-1.77,-0.01],Z=1.97,p=0.05) of exercise compared to the control group at post-intervention. However, statistical heterogeneity was high (I2=91%,X2=53.14,df=5,p<0.00001). The removal of two papers during sensitivity analysis for missing data/baseline differences showed a large significant effect (SMD=-1.01,[95%CI:-1.45,-0.57],Z=4.48,p=<0.00001). The statistical heterogeneity was low (I2=39%,X2=4.94,df=3,p=0.18). The results demonstrate a significant trend towards a decrease in depressive symptoms for participants in the exercise compared to no exercise group; aerobic exercise compared to normal routine activity group; aerobic and resistance exercise compared to other control groups. Narrative synthesis demonstrates the beneficial effects of exercise training on outcome measures: anxiety and cognitive function, apart from other psychological benefits. There was limited and no RCTs on the effects of exercise on physical activity level and social participation, respectively.Conclusion: Combined exercise (Aerobic exercise+Strength training; 80mins/session; 3X/week for 12weeks.) + routine counselling OR Aerobic exercise training+counselling 40mins per session; 3X/week for 6weeks OR Combined exercise: Aerobic and Resistance exercise training 50mins/session; 2X/week for 6weeks OR Combined exercise: Aerobic and Resistance exercise training 60mins/session; 3X/week for 24weeks OR Aerobic exercise training 60mins per session; 3X per week for 12weeks may improve mood disorders while therapeutic exercise(2X per week for 6weeks) may improve psychological wellbeing.

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Background: Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: What is the extent to which physical exercise training affected symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of interventions, usual care, or no treatment controls? Objectives: To assess the impact of physical exercise training on symptoms of depression, PAL and social participation in PLWHA. Data sources: Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Study eligibility criteria: Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Data collection and analysis: Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I2). Results: Thirteen studies met the inclusion criteria with 779 participants (n=596 participants on study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18-86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2-3 times/week, at 40-60 minutes/session, and for between 6-24 weeks, and the risk of bias varied from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD=-0.74, 95% confidence interval (CI)=-1.01,-0.48,p=<0.0002;I2=47%;5studies; 205participants) unlike PAL (SMD=0.98,95%CI=-0.25,2.17,p=0.11;I2=82%;2studies;62 participants) and social participation (SMD=0.04,95%CI=-0.65,0.73,p=0.91;I2=90%; 6 studies; 373 participants).Conclusion: Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect their PAL and social participation. However, the high heterogeneity in the included studies, imply that adequately powered RCTs with clinical/methodological similarity are required in future studies.Registration number: INPLASY202040048