Diet and Activity Deficits Persist in People With HIV

Less than 10% of adults living with HIV in the United States meet recommendations for physical activity and a healthy diet, based on data from approximately 700 individuals in the PROSPER-HIV study.

Healthy lifestyle behaviors, physical activity and a healthy diet, can reduce the risk for comorbidities and extend the period of healthy living in adults with HIV, said Vitor Oliveira, PhD, and colleagues in a poster presented at the Association of Nurses in AIDS Care (ANAC) 2024 Annual Meeting.

Although HIV gets less media attention than in the past, approximately 1.2 million people in the United States are living with HIV, said Oliveira, research assistant professor in the Department of Biobehavioral Nursing and Health Informatics at the University of Washington, Seattle, in an interview.

“With appropriate treatment, these patients can have a life expectancy close to the observed among people without HIV,” he said. However, aging with HIV is a challenge; HIV is associated with many comorbidities that require extra medication, and many people with HIV (PWH) also have poor social determinants of health affecting their health and well-being, he added.

The goal of the PROSPER-HIV study is to investigate these behaviors among PWH, Oliveira said. The study followed 706 PWH in four cities in the United States over a 3-year period and assessed them for physical activity, quality of diet, and level of physical function. They also assessed behaviors by gender. The mean age of the participants was 57 years; 159 were women.

Overall, less than 10% of participants met criteria for both diet and physical activity guidelines, the majority of whom were men.

Just under half (47%) of the participants met healthy diet criteria based on the Healthy Eating Index 2015 (HEI-2015) total score. Overall diet quality was significantly better among men than among women, with higher HEI subscores in areas of whole grains, fruits, and vegetables.

However, men consumed significantly more alcohol than women, the researchers noted.

Approximately 40% of the participants overall met recommendations for physical activity of at least 150 minutes of moderate to vigorous physical activity per week, but significantly more men did so (44.8% vs 27.7%; P P

The study findings were surprising in that the values were worse than expected, Oliveira said. “When compared to the general population, the physical activity levels and diet quality of people with HIV are much worse. When comparing men and women with HIV, physical activity levels and diet quality are much worse among women,” he said.

The takeaway from the study is the great need for improvement of lifestyle behaviors in PWH, Oliveira told Medscape Medical News. Notably, “physical activity and diet can strongly influence the health and symptoms experienced by the patients, and they should be educated and encouraged to adopt healthy choices,” he said. However, a current and persistent major research gap is how to integrate physical activity and healthy diet programs into routine clinical care, he added.

Reasons for Gender Differences Remain Unclear

Lifestyle factors such as diet and physical activity can have a significant impact on overall health and health-related outcomes for all individuals, Shirin Mazumder, MD, associate professor and infectious disease specialist at The University of Tennessee Health Science Center, Memphis, Tennessee, in an interview.

“Looking at how different groups are impacted by these factors can help to determine where interventions can be directed to promote adherence to healthy behaviors,” she said. In the current study of people living with HIV, “I was surprised to see that there was such a large difference between men and women when it came to diet guideline adherence,” she added.

Overall, the population living with HIV in the current study had poor physical activity levels, with less than half meeting physical activity guidelines, and the data highlight the need for promotion of healthy lifestyle modifications among people living with HIV, Mazumder told Medscape Medical News. Although the women included in this study had a poorer diet quality and a lower physical activity level than men, the disproportionately lower number of women was a limiting factor, she said.

As for additional research, future studies with a larger cohort of women may provide additional insights, said Mazumder. “Including a wide range of patient ages and looking at how well underlying HIV infection is controlled may be important considerations in a future study,” she said. “Assessing access to healthy foods and physical activity education may be barriers for some people, and evaluating these factors may help to guide further intervention,” she added.

The PROSPER-HIV study is funded by the National Institute of Nursing Research.

The researchers and Mazumder had no financial conflicts to disclose.