The Relationship Between Physical Activity and Cardiorespiratory Fitness Among People Living With Human Immunodeficiency Virus Throughout the Life Span

Abstract

Background: People living with human immunodeficiency virus (PLHIV) are at an increased risk for developing cardiovascular disease (CVD). Physical activity and cardiorespiratory fitness in PLHIV are poorly understood. Objective: The aims of this study were to describe physical activity and cardiorespiratory fitness by sex and age and to examine the association between physical activity and cardiorespiratory fitness in PLHIV, controlling for covariates. Methods: Seven hundred two PLHIV participated in a cross-sectional study and completed validated measures of self-reported physical activity (7-day Physical Activity Recall) and cardiorespiratory fitness (6-minute walk test). Participants were recruited from 7 diverse sites in the United States and Thailand, and data were analyzed using descriptive statistics and multiple regression to examine the relationship between physical activity and cardiorespiratory fitness. Results: On average, participants self-reported engaging in 115 minutes of, mostly light (75%), physical activity. Men reported twice the amount of physical activity as women (155 vs 73 minutes, P = .01). Participants' ability to achieve their predicted 6-minute walk test distances was similar between men (68%) and women (69%) (P > .01). For women, vigorous physical activity was associated with a 6.6% increase in cardiorespiratory fitness and being temporarily unemployed was associated with an 18% decline in cardiorespiratory fitness. Cardiorespiratory fitness increased with age (P < .01). Conclusions: Weekly physical activity of people living with human immunodeficiency virus averaged 85 minutes of mostly light activity, well below the recommended 150 minutes of moderate activity. Vigorous physical activity was associated with improved cardiorespiratory fitness in women, but not men. Although PLHIV would benefit from interventions to increase physical activity, our data suggest a need to develop sex-specific physical activity strategies.

Physical Activity Patterns and Health-Related Fitness Indicators in Adults Living with HIV in South Texas

“…This study was conducted as part of the International Nursing Network for HIV Research's multi-site crosssectional study to describe PA and cardiorespiratory fitness by sex and age in PLHIV (Holzemer 2007;Webel et al 2019b). Consistent with this network's procedural framework, a coordinating site (Case Western Reserve University) finalized the study protocol, developed the standardized training modules, and obtained the primary Institutional Review Board (IRB) approval.…”

Metabolic Changes in Pediatric HIV-Positive Patients and Potential Lifestyle Interventional Strategies

“…The lack of physical activity in the pediatrics HIV population is particularly concerning since early implementation promotes healthy habits as adults. In a study with HIV-positive women, those that reported vigorous activity did demonstrate cardiorespiratory fitness improvements [13]. This signifies that the type of exercise, intensity, and duration of physical activity all play a role in reducing the impact of HIV-associated metabolic changes.…”

“…When applying physical activity to the HIV-positive pediatric population, it is once again important to determine the unique challenges that face them. In general, the HIV population has been found to have not only lower self-reported activity levels, but those who did report were more likely to mention light activity levels [13]. When looking specifically at children with HIV, the majority of children preferred low-impact exercise such as soccer and walking in boys and jogging and walking in girls [24].…”

“…It is well-documented that a healthy, balanced diet can positively impact cardiometabolic changes in both the general and HIV-positive populations [11][12][13]. Starting nutritional intervention early in life can endorse healthy habits into adulthood and prevent cardiometabolic adverse effects.…”

“…Furthermore, barriers to a healthy diet must be considered on an individual basis. Typical barriers include the cost of the diet, time to prepare the foods, and lack of housing while those particular to the HIV population include appetite changes due to ART as well as depression and psychiatric illnesses [13]. Factors associated with diet adherence include access to medical professionals giving diet-specific advice, using personal motivators such as weight loss and appearance, and having cost-effective options [17].…”