Objectively measured physical activity among people with and without HIV in Uganda: associations with cardiovascular risk and coronary artery disease.

Background: Africa has a disproportionate burden of HIV-related cardiovascular disease. We aimed to describe physical activity in people living with HIV (PLHIV) and people without HIV (PWOH) in Uganda and characterize its relationship with the presence of computed tomography angiography-detected (CCTA) coronary artery disease (CAD). Methods: We performed a cross-sectional analysis of the Ugandan Study of HIV Effects on the Myocardium and Atherosclerosis using Computed Tomography (mUTIMA-CT) cohort. From 2017-2019, physical activity in PLHIV and PWOH was assessed by accelerometry over seven days. Participants additionally underwent CCTA. Univariable and multivariable modified Poisson regression was used to analyze the relationship between physical activity and CAD presence. Results: 168 participants were analyzed. The median (IQR) age was 57 (53-58) years old and 64% were female. Males had more moderate-to-vigorous physical activity per week [68 minutes (12-144) vs 15 minutes (0-50), P<0.001] and less light physical activity [788 minutes (497-1,202) vs [1,059 (730-1490), P=0.001] compared to females, but there was no difference by HIV status. After adjusting for age, which accounted for 10% of the variation in steps taken, and sex, no significant associations were found between physical activity and coronary plaque. Conclusion: Objectively measured physical activity was low compared to guideline recommendations, with males being somewhat more active than females and without significant differences by HIV status. Physical activity was not associated with the presence of CAD independently of age and sex.

A Mixed Methods, Observational Investigation of Physical Activity, Exercise, and Diet Among Older Ugandans Living With and Without Chronic HIV Infection.

ABSTRACT: People living with HIV (PLWH) are at increased risk for cardiovascular disease. Physical activity, exercise, and controlled diet can mitigate this risk, yet these behaviors are understudied in sub-Saharan Africa. Our objective was to describe and compare the meaning, value, and patterns of physical activity, exercise, and diet among PLWH and older adults without HIV in Uganda. This mixed methods, observational study included 30 adult PLWH and 29 adults without HIV who (a) wore an accelerometer to measure physical activity; (b) had weight, height, and waist and hip circumference measured; (c) completed physical fitness measures; and (d) used digital cameras to record photographs and videos of their typical diet and physical activities. Participants were approximately 58 years old and 68% female. Approximately 20% of PLWH and 40% of adults without HIV met physical activity guidelines (p > .05). Qualitative themes included engaging in a variety of exercise, structural barriers to exercising, and typical meals. Older adults in Uganda have low levels of physical activity and homogenous diets, increasing their risk for cardiovascular disease.