Physical Activity Intensity is Associated with Symptom Distress in the CNICS Cohort


Symptom distress remains a challenging aspect of living with HIV. Physical activity is a promising symptom management strategy, but its effect on symptom distress has not been examined in a large, longitudinal HIV-infected cohort. We hypothesized that higher physical activity intensity would be associated with reduced symptom distress. We included 5370 people living with HIV (PLHIV) who completed patient-reported assessments of symptom distress, physical activity, alcohol and substance use, and HIV medication adherence between 2005 and 2016. The most frequent and burdensome symptoms were fatigue (reported by 56%), insomnia (50%), pain (46%), sadness (45%), and anxiety (45%), with women experiencing more symptoms and more burdensome symptoms than men. After adjusting for age, sex, race, time, HIV medication adherence, alcohol and substance use, site, and HIV RNA, greater physical activity intensity was associated with lower symptom intensity. Although individual symptoms may be a barrier to physical activity (e.g. pain), the consistent association between symptoms with physical activity suggests that more intense physical activity could mitigate symptoms experienced by PLHIV.


La carga de síntomas sigue siendo un aspecto problemático para personas que viven con VIH. La actividad física es una prometedora estrategia de manejo, pero su efecto sobre la carga de síntomas no ha sido examinado en estudios grande longitudinales de cohortes. Nuestra hipótesis es que una mayor intensidad de actividad física puede estar asociada con una reducción de la carga de síntomas. En este estudio, incluimos 5.370 personas viviendo con VIH (PVV) que completaron cuestionarios estandarizados de carga de síntomas, actividad física, uso de alcohol y drogas, y adherencia a medicamentos entre 2005 y 2016. Los síntomas más frecuentes y con mayor impacto fueron cansancio (descrito por 56%), insomnio (50%), dolor (46%), tristeza (45%), y ansiedad (45%). Las mujeres describieron mayor número y mayor carga de síntomas que los hombres. Después de ajustar por edad, sexo, raza, tiempo, adherencia a antiretrovirales, uso de alcohol y drogas, sito y carga viral, una mayor actividad física estuvo asociada con una menor intensidad de síntomas. Aunque algunos síntomas individuales pueden ser una barrera para la actividad física (como el dolor, por ejemplo), la consistente asociación entre síntomas y actividad física en nuestro estudio sugiere que una mayor intensidad de actividad física podría mitigar algunos de los síntomas que experimentan las PVV.

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This project was funded by grants from the National Institutes of Health (R24 AI067039) made possible by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Heart, Lung, and Blood Institute (NHLBI) and by the National Institute of Nursing Research (NINR) (R01 NR018391).

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Correspondence to Allison R. Webel.

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Webel, A.R., Willig, A.L., Liu, W. et al. Physical Activity Intensity is Associated with Symptom Distress in the CNICS Cohort. AIDS Behav 23, 627–635 (2019).

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  • HIV
  • Symptoms
  • Physical Activity
  • Pain