Active Living and HIV

An ecological understanding of physical activity patterns of adults living with HIV throughout the lifespan.

People living with HIV (PLHIV) acquire additional chronic diseases earlier and more often than non-HIV infected counterparts. Not only do HIV-infected  adults  have more co-occurring illnesses, they develop illnesses an average of 5 years sooner than persons without HIV. While there is strong evidence that traditional factors such as smoking and dyslipidemia contribute to this increased risk of multimorbidity, there appears to be residual risk that is due to HIV-specific factors (i.e. HIV antiretroviral (ART) use, chronic immune activation and/or inflammation). There is an urgent need for research on behaviors and lifestyle factors that reduce the risk of chronic disease development in PLHIV.  Exercise is an evidence-based treatment which can help prevent and/or mitigate chronic diseases by improving insulin sensitivity, decreasing visceral fat, mitigating the inflammatory response, increasing endothelial function, and optimizing lipid profiles. Exercise has also been shown to decrease distressing symptoms (i.e. depression and fatigue) that are of significant burden to PLHIV, and recent evidence suggests exercise may help mitigate cognitive impairment, a comorbidity that is also elevated in this population. In order for the exerciser to achieve these benefits, they require regular, sustained exercise, often in a home setting; yet subject-initiated exercise and physical activity has been rarely studied among PLHIV.

We do not know if PLHIV have different physical activity, exercise, and physical fitness patterns than those living with other chronic diseases, but there are some unique features of HIV that suggest there may be differences. HIV has a significant, often isolating, stigma; it is associated with a high symptom burden; and it is associated with multimorbidity and accompanying self-management work. This study will help us to begin to understand how these factors are interwoven perhaps helping us to identify potential HIV-specific intervention targets. 

The purpose of this multi-site observational study is to describe patterns of physical activity, exercise, and physical fitness in adults living with HIV grounded in the ecological model of healthy living throughout the lifespan. We ask the following research questions:

1. What are the physical activity, exercise, and physical fitness patterns of adults living with HIV, through the lifespan?

2. What are the relationships between exercise and physical activity and interpersonal, environmental behavioral setting, and policy characteristics?

3. How does multimorbidity modify the relationship between physical activity and symptom intensity in adults living with HIV, controlling for age?

Upcoming Network Meetings

We look forward to seeing many of you at our next network meeting in San Francisco, CA, on July 10-11, 2020. Check back frequently for more information about registration and the agenda. To receive our quarterly newsletter, please contact Allison Webel to be added to the distribution list.

Study VII Site Investigators

As enrollment comes to end, please review the Study VII publication policy and complete this data use form to propose using Study VII data. As a reminder, all investigators can use their own site data, but we ask that you complete this form so we can track what data are being used and where they will be presented.  Feel free to Contact Dr. Webel with questions.

Study VII Publication Policy

Study VII Data Use Form

Study VIII: We are looking for new ideas for Study VIII protocol. This network is an amazing resource to answer clinically-relevant research questions. If you are thinking about a study and have an interest in developing it, please let us know. We hope to bring several 1-2 page concept papers to our Jan 2018 meeting and have a rousing discussion. We are here to help you develop the proposal, so please contact Carol, Allison or Craig if you have any questions.


Protocol Chair: Allison R. Webel, RN, PhD Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA

Protocol Co-Chair: J. Craig Phillips RN, PhD, FAAN School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada

Project Director: Joseph Perrazo PhD, RN  Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA

Research Publications

Webel, A.R., Perazzo, J., Phillips, J.C., Nokes, K.M., Rentrope, C., Schnall, R., Musanti, R., Tufts, K.A., Sefcik, E., Hamilton, M.J., Portillo, C., Chaiphibalsarisdi, P., Orton, P., Davis, L., Dawson, Rose, C. (2019) The Relationship Between Physical Activity and Cardiorespiratory Fitness Among People Living with HIV Throughout the Lifespan.. Journal of Cardiovascular Nursing. ep/Oct;34(5):364-371

Davis, L., Sefcik, E., Kesterson, M., Hamilton, M. J., & Webel, A. R. Physical activity patterns and health-related fitness indicators in adults living with HIV in South Texas. 2020 Society of Health and Physical Educators (SHAPE America) National Convention & Exposition, Salt Lake City, UT.