Physical Activity and Health Outcomes Among HIV-Infected Men Who Have Sex with Men: A Longitudinal Mediational Analysis
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Low physical activity is associated with depression, which may, in turn, negatively impact antiretroviral therapy (ART) adherence among HIV-infected individuals; however, prior studies have not investigated the relationships between physical inactivity and ART non-adherence.
The purpose of this study was to examine the association of physical inactivity, depression, ART non-adherence, and viral load in HIV-infected men who have sex with men.
The sample (N = 860) was from a large, multicenter cohort of HIV-infected patients engaged in clinical care.
Across time, depression mediated the relationship between physical inactivity and ART non-adherence (γ = 0.075) and the relationship between physical inactivity and viral load (γ = 0.05). ART non-adherence mediated the relationship between depression and viral load (γ = 0.002) and the relationship between physical inactivity and viral load (γ = 0.009).
Low levels of physical activity predicted increased depression and poor ART adherence over time, which subsequently predicted higher viral load.
KeywordsHIV/AIDS Physical activity Depression Adherence Viral load
- 1.Thompson PD, Buchner D, Pina IL, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: A statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation. 2003;107:3109-3116.PubMedCrossRefGoogle Scholar
- 15.LaPerriere AR, Antoni MH, Schneiderman N, et al. Exercise intervention attenuates emotional distress and natural killer cell decrements following notification of positive serologic status for HIV-1. Appl Psychophysiol Biofeedback. 1990;15:229-224.Google Scholar
- 17.Carrico AW, Antoni MH. Effects of psychological interventions on neuroendocrine hormone regulation and immune status in HIV-positive persons: A review of randomized controlled trials. Psychosom Med. 2008; 70:557–584.Google Scholar
- 18.CDC (Centers for Disease Control and Prevention). CDC analysis provides new look at disproportionate impact of HIV and syphilis among U.S. gay and bisexual men. Available at http://www.cdc.gov/nchhstp/Newsroom/msmpressrelease.html. Accessed 20 August 2012.
- 33.Fredericksen R, Crane PK, Tufano J, et al. Integrating a web-based, patient-administered assessment into primary care for HIV-infected adults. J Acquir Immune Defic Syndr. 2012;4:47-55.Google Scholar
- 38.Feldman BJ, Fredericksen RJ, Crane PK, et al. Evaluation of the single-item self-rating adherence scale for use in routine clinical care of people living with HIV. AIDS Behav. 2013;17:307–318.Google Scholar
- 46.Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. In: Leinhardt S, ed. Sociological Methodology. Washington, DC: American Sociological Association; 1982:290-312.Google Scholar
- 48.Selig JP, Preacher KJ. Monte Carlo method for assessing mediation: An interactive tool for creating confidence intervals for indirect effects. Available at http://www.quantpsy.org/medmc/medmc.htm. Accessed 20 August 2012.
- 50.Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum; 1988.Google Scholar
- 51.Kelley K. Confidence intervals for standardized effect sizes: Theory, application, and implementation. J Stat Softw. 2007;20:1-24.Google Scholar
- 53.Kelley K, Lai K. MBESS (version 3.2.0) Computer Software and Manual. Available at http://www.cran.r-project.org/.
- 56.Santos-Lozano A, Garatachea N. Physical activity measurements using accelerometers and pedometers in HIV-infected people. J AIDS Clinic Res. 2011;2:126.Google Scholar
- 64.Jacobson NS, Martell CR, Dimidjian S. Behavioral activation treatment for depression: Returning to contextual roots. Clin Psychol. 2001;8:255-270.Google Scholar
- 67.Mazzuchelli T, Kare R, Rees C. Behavioral activation treatments for depression in adults: A meta-analysis and review. Clin Psychol. 2009;16:383-411.Google Scholar