[High prevalence of physical inactivity among adolescents living with HIV/Aids]

Influence of Healthy Habits Counseling on Biochemical and Metabolic Parameters in Children and Adolescents with HIV: Longitudinal Study

We analyze the influence of dietary counseling and physical activity on biochemical and metabolic parameters in children and adolescents with HIV. A longitudinal experimental study, including three analyses: At the beginning, 4th month, and 8th month. A sample of 18 subjects with HIV of both sexes, mean age 10.4 ± 4.50 years. Usual food intake (24 h recall and food intake marker), level of habitual physical activity, biochemical parameters, resting metabolic rate, as well as body composition (dual-energy X-ray absorptiometry), biological maturation, and anamnesis with clinical data and socioeconomic were evaluated. There was an effect of time on the reduction of blood glucose and triglycerides and the resting metabolic rate. There was a significant increase in fruit consumption throughout the study. The consumption of soft drinks decreased when comparing analysis periods 1 and 2, however, it increased again in analysis period 3. There was no significant effect of time on the set of variables related to a food recall. Counseling healthy habits and regular clinical follow-up were relevant for improving biochemical parameters (glucose, triglyceride, HDL cholesterol), maintaining the resting metabolic rate, increasing fruit consumption, and decreasing the consumption of soft drinks, in part of the time, of children and adolescents with HIV. Finally, we emphasize that counseling positively influenced healthy habits, and these, in turn, improved health-related parameters.

Comparison of Muscle Strength, Aerobic Capacity and Body Composition between Healthy Adolescents and Those Living with HIV: A Systematic Review and Meta-Analysis

Background: The adverse effects of antiretroviral therapy associated with complications generated by human immunodeficiency virus (HIV) promote impairments in physical fitness in adolescents. Objective: To analyze the aerobic capacity, muscle strength, and body composition of adolescents living with HIV compared with a healthy population of the same age. Methods: Searches were performed in the MEDLINE, Embase, Web of Science, Scopus and SportDiscus databases until September 2019 and updated in April 2020. Eligibility Criteria: adolescents of both sexes in the age group from 10 to 19 years; living with HIV; cross-sectional, case–control, cohort studies; comparing with a healthy population. Mean differences and 95% Confidence intervals (CIs) were calculated using RevMan (software for systematic reviews). Results: Five articles were included, involving 197 adolescents living with HIV (16 to 18 years) and 185 without infection (13 to 18 years), with the sample in each study ranging from 15 to 65 adolescents. Aerobic capacity and muscle strength were reduced in adolescents with HIV, and body mass index was also significantly lower in this group. Conclusion: Adolescents living with HIV have impaired cardiorespiratory fitness, muscle strength, and body composition when compared to their uninfected peers. However, this systematic review provides limited evidence on the differences between the physical fitness outcomes of adolescents living with HIV compared to healthy adolescents.

Development of a context-sensitive physical activity intervention for persons living with HIV and AIDS of low socioeconomic status using the behaviour change wheel

Background

Regular physical activity (PA) has been recommended for the management of HIV and AIDS. The purpose of this study was to develop a contextualised intervention for promoting PA among women living with HIV and AIDS (WLWHA) of low socioeconomic status (SES). A secondary aim of the study was to optimise the PA intervention using behavioural theory/ frameworks derived from preliminary studies and the literature.

Methods

The Behaviour Change Wheel (BCW) for designing behaviour change interventions was used. This method was further supplemented by evidence from the literature, systematic literature review (SLR), a concurrent mixed methods study and two cross-sectional studies. The SLR aided in determining the theoretical frameworks to inform the intervention, the specific PA behaviours to be targeted by the intervention, the intervention functions, the intervention policy category and the mode of delivery of the intervention. The concurrent mixed methods study was used to identify key factors that needed to change in order for participants to engage in regular PA. The first cross-sectional study was used to determine the gender to be targeted by the study. The second cross-sectional study was used to determine the domain and intensity of PA to target in the intervention.

Results

A face-to-face context-sensitive PA intervention employing 14 behavioural change techniques was designed. The PA intervention (a) utilised the Transtheoretical model of behaviour change and the Social Cognitive theory as the underpinning theoretical frameworks (b) included convenient PAs, such as walking, doing simple home-based exercises, engaging in activities of daily living or doing simple exercises at the community centre (c) used education, reward, training in PA, modelling exercise activities and enablement to increase the opportunity to engage in PA as intervention functions (d) used service provision as policy priorities, and (e) used a direct face-to-face mode of delivery.

Conclusions

The PA intervention emphasises behavioural techniques for increasing PA participation, such as goal-setting, self-monitoring, strategies for overcoming PA barriers, social support and rewards. The intervention employs strategies that highlight low-cost local PA resources and opportunities to help HIV infected women of low SES to participate in PA. The BCW provides a useful and comprehensive framework for the development of evidence and theory-based PA interventions for PLWHA of low SES. The BCW can thus be used in the development of interventions that ‘talk’ to policy by bridging the health inequality gap.

Low Levels of Physical Activity Among Older Persons Living with HIV/AIDS Are Associated with Poor Physical Function

Antiretroviral therapy (ART) has prolonged lives of persons living with HIV/AIDS (PLWHA), resulting in greater incidence of aging-related diseases and disability. Physical activity (PA) is recommended for healthy aging, but little is known about PA in older PLWHA. The purpose of this study was to objectively assess PA levels in older PLWHA and the associations with physical function. Twenty-one PLWHA, ≥50 years old, on ART with undetectable HIV-1 viral loads, wore an accelerometer to assess PA, including number of steps, activity intensity, and energy expenditure over 7 days. A physical function performance battery assessing aerobic capacity, strength, and gait speed was also completed. Average age was 66, and 67% were male. An average of 3,442 (interquartile range: 4,613) steps were walked daily, with 254.9 kcals expended. Participants spent most waking hours (75%) sedentary, with minimal hours (24%) in light-intensity activity. Only 5 min per day (35 min per week), on average, were spent in moderate-to-vigorous physical activity (MVPA). Maximal gait speed and 6-min walk test significantly correlated (p < .05) with all PA outcomes. Usual gait speed significantly correlated with all PA outcomes, except for daily kcals and light-intensity activity. Greater PA was associated with better physical performance, while high sedentary time was associated with poorer performance. To our knowledge, this is the first study to objectively measure PA in older PLWHA. Our findings indicate that older PLWHA accumulate substantial sedentary time. Most (86%) do not achieve recommended MVPA levels. This activity profile was associated with poor physical function. Providers should promote PA among PLWHA.

PHYSICAL ACTIVITY AND BODY FAT IN ADOLESCENTS LIVING WITH HIV: A COMPARATIVE STUDY

OBJECTIVE

To compare regular physical activity among adolescents living with human immunodeficiency virus (HIV) with their healthy peers, and to evaluate the relationship with anthropometric indicators of body fat.

METHODS

This was a cross-sectional study which investigated two groups: 57 adolescents (10-15 years of age) living with HIV, and 54 apparently healthy adolescents matched for sex and age. Physical activity was evaluated using a questionnaire and anthropometric measurements were performed. The groups were compared in terms of physical activity, and the linear and partial correlations (adjusted for age and sex) between physical activity and the anthropometric indicators were tested.

RESULTS

Adolescents living with HIV had a lower total activity score than their healthy peers (1.73 versus 2.14; p<0.001), but participated more frequently in physical education activities. Soccer and walking were the physical activities most frequently reported by adolescents of the two groups. No correlation was observed between total physical activity score and anthropometric indicators of body fat when adjusted for sex and age. Female gender (β=21.51), months of exposure to antiretroviral therapy (β=1.26), and socioeconomic classes B and C (β=22.05 and 28.15, respectively) explained 33% of the sum of skinfolds in adolescents living with HIV (F=6.70; p<0.001).

CONCLUSIONS

Adolescents living with HIV have lower physical activity scores compared with their healthy peers, but physical education was found to be an opportunity to increase physical activity.

Obesity in patients with HIV infection: epidemiology, consequences and treatment options

Even though wasting used to characterize patients with HIV infection prior to the antiretroviral therapy (ART) era, obesity is becoming increasingly prevalent in this population. Areas covered: In the present review, we discuss the epidemiology, consequences and treatment options for obesity in patients with HIV infection. Expert commentary: Obesity exerts a multitude of detrimental cardiometabolic effects and appears to contribute to the increasing cardiovascular mortality of this population. However, there are very limited data on the optimal management of obesity in patients with HIV infection. Given the potential for interactions between antiobesity agents and ART that might compromise viral control, lifestyle changes should represent the cornerstone for the prevention and management of obesity in HIV infection.