nach oben

Erschienen in:

01.10.2013 | Original Article

Physical Activity and Health Outcomes Among HIV-Infected Men Who Have Sex with Men: A Longitudinal Mediational Analysis

verfasst von: Aaron J. Blashill, Ph.D., Kenneth H. Mayer, M.D, Heidi Crane, M.D., Jessica F. Magidson, M.S., Chris Grasso, M.P.H., W. Christopher Mathews, M.D., M.S.P.H., Michael S. Saag, M.D., Steven A. Safren, Ph.D.

Erschienen in: Annals of Behavioral Medicine | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

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.

Purpose

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.

Methods

The sample (N = 860) was from a large, multicenter cohort of HIV-infected patients engaged in clinical care.

Results

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).

Conclusions

Low levels of physical activity predicted increased depression and poor ART adherence over time, which subsequently predicted higher viral load.

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.PubMedCrossRef

Grinspoon S, Carr A. Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med. 2005;352:48-62.PubMedCrossRef

Samaras K. Prevalence and pathogenesis of diabetes mellitus in HIV-1 infection treated with combined antiretroviral therapy. J Acquir Immune Defic Syndr. 2009;50:499-505.PubMedCrossRef

Brown TT, McComsey GA, King MS, Qaqish RB, Bernstein BM, da Silva BA. Loss of bone mineral density after antiretroviral therapy initiation, independent of antiretroviral regimen. J Acquir Immune Defic Syndr. 2009;51:554-561.PubMedCrossRef

Patel P, Hanson DL, Sullivan PS, et al. Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992–2003. Ann Intern Med. 2008;148:728-736.PubMedCrossRef

Ciccolo JT, Jowers EM, Bartholomew JB. The benefits of exercise training for quality of life in HIV/AIDS in the post-HAART era. Sports Med. 2004;34:487-499.PubMedCrossRef

Dudgeon WD, Phillips KD, Bopp CM, Hand GA. Physiological and psychological effects of exercise interventions in HIV disease. AIDS Patient Care STDS. 2004;18:81-98.PubMedCrossRef

Neidig JL, Smith BA, Brashers DE. Aerobic exercise training for depressive symptom management in adults living with HIV infection. J Assoc Nurses AIDS Care. 2003;14:30-40.PubMedCrossRef

Wagner G, Rabkin J, Rabkin R. Exercise as a mediator of psychological and nutritional effects of testosterone therapy in HIV+ men. Med Sci Sports Exerc. 1998;30:811-817.PubMedCrossRef

10.

Rigsby LW, Dishman RK, Jackson AW, Maclean GS, Raven PB. Effects of exercise training on men seropositive for the human immunodeficiency virus-1. Med Sci Sports Exerc. 1992;24:6-12.PubMed

11.

Smit E, Crespo CJ, Semba RD, et al. Physical activity in a cohort of HIV-positive and HIV-negative injection drug users. AIDS Care. 2006;18:1040-1045.PubMedCrossRef

12.

Smith BA, Neidig JL, Nickel JT, Mitchell GL, Para MF, Fass RJ. Aerobic exercise: Effects on parameters related to fatigue, dyspnea, weight and body composition in HIV-infected adults. AIDS. 2001;15:693-701.PubMedCrossRef

13.

Stringer WW, Berezovskaya M, O’Brien WA, Beck CK, Casaburi R. The effect of exercise training on aerobic fitness, immune indices, and quality of life in HIV+ patients. Med Sci Sports Exerc. 1998;30:11-16.PubMed

14.

Bopp CM, Phillips KD, Fulk LJ, Dudgeon WD, Sowell R, Hand GA. Physical activity and immunity in HIV-infected individuals. AIDS Care. 2004;16:387-393.PubMedCrossRef

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.

16.

Antoni MH, Carrico AW, Durán RE, et al. Reductions in depressed mood and denial coping during cognitive behavioral stress management with HIV-positive gay men treated with HAART. Ann Behav Med. 2006;31:155-164.PubMedCrossRef

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.

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.

19.

Ledergerber B, Egger M, Opravil M, et al. Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: A prospective cohort study. Swiss HIV Cohort Study. Lancet. 1999;353:863-868.PubMedCrossRef

20.

Ambrosioni J, Calmy A, Hirschel B. HIV treatment for prevention. J Int AIDS Soc. 2011;14:28.PubMedCrossRef

21.

Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493-505.PubMedCrossRef

22.

Leserman J. Role of depression, stress, and trauma in HIV disease progression. Psychosom Med. 2008;70:539-545.PubMedCrossRef

23.

Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: A review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58:181-187.PubMed

24.

Carrico AW, Bangsberg DR, Weiser SD, Chartier M, Dilworth SE, Riley ED. Psychiatric correlates of HAART utilization and viral load among HIV-positive impoverished persons. AIDS. 2011;25:1113-1118.PubMedCrossRef

25.

Cook JA, Cohen MH, Grey D, et al. Use of highly active antiretroviral therapy in a cohort of HIV-seropositive women. Am J Public Health. 2002;92:82-87.PubMedCrossRef

26.

Ickovics JR, Hamburger ME, Vlahov D, et al. Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: Longitudinal analysis from the HIV Epidemiology Research Study. JAMA. 2001;285:1466-1474.PubMedCrossRef

27.

Ironson G, O’Cleirigh C, Fletcher MA, et al. Psychosocial factors predict CD4 and viral load change in men and women with human immunodeficiency virus in the era of highly active antiretroviral treatment. Psychosom Med. 2005;67:1013-1021.PubMedCrossRef

28.

Li X, Margolick JB, Conover CS, et al. Interruption and discontinuation of highly active antiretroviral therapy in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr. 2005;38:320-328.PubMed

29.

Patterson T, Shaw W, Semple S, Cherner M. Relationship of psychosocial factors to HIV disease progression. Ann Behav Med. 1996;18:30-39.CrossRef

30.

Pence BW, Miller WC, Gaynes BN, Eron JJ Jr. Psychiatric illness and virologic response in patients initiating highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2007;44:159-166.PubMedCrossRef

31.

Kitahata MM, Rodriguez B, Haubrich R, et al. Cohort profile: The Centers for AIDS Research Network of Integrated Clinical Systems. Int J Epidemiol. 2008;37:948-955.PubMedCrossRef

32.

Crane HM, Lober W, Webster E, et al. Routine collection of patient-reported outcomes in an HIV clinic setting: The first 100 patients. Curr HIV Res. 2007;5:109-118.PubMedCrossRef

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.

34.

Lawrence ST, Willig JH, Crane HM, et al. Routine, self-administered, touch-screen, computer-based suicidal ideation assessment linked to automated response team notification in an HIV primary care setting. Clin Infect Dis. 2010;50:1165-1173.PubMedCrossRef

35.

Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282:1737-1744.PubMedCrossRef

36.

Ainsworth BE, Jacobs DR Jr, Leon AS. Validity and reliability of self-reported physical activity status: The Lipid Research Clinics questionnaire. Med Sci Sports Exerc. 1993;25:92-98.PubMedCrossRef

37.

Lu M, Safren SA, Skolnik PR, et al. Optimal recall period and response task for self-reported HIV medication adherence. AIDS Behav. 2008;12:86-94.PubMedCrossRef

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.

39.

Simoni JM, Kurth AE, Pearson CR, Pantalone DW, Merrill JO, Frick PA. Self-report measures of antiretroviral therapy adherence: A review with recommendations for HIV research and clinical management. AIDS Behav. 2006;10:227-245.PubMedCrossRef

40.

West BT. Analyzing longitudinal data with the linear mixed models procedure in SPSS. Eval Health Prof. 2009;32:207-228.PubMedCrossRef

41.

Bauer DJ, Preacher KJ, Gil KM. Conceptualizing and testing random indirect effects and moderated mediation in multilevel models: New procedures and recommendations. Psychol Methods. 2006;11:142-163.PubMedCrossRef

42.

Mackinnon DP, Lockwood CM, Williams J. Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivar Behav Res. 2004;39:99-128.CrossRef

43.

Shrout PE, Bolger N. Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychol Methods. 2002;7:422-445.PubMedCrossRef

44.

Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173-1182.PubMedCrossRef

45.

Hayes A. Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Commun Monogr. 2009;76:408-420.CrossRef

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.

47.

Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40:879-891.PubMedCrossRef

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.

49.

Preacher KJ, Kelley K. Effect size measures for mediation models: Quantitative strategies for communication indirect effects. Psychol Methods. 2011;16:93-115.PubMedCrossRef

50.

Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum; 1988.

51.

Kelley K. Confidence intervals for standardized effect sizes: Theory, application, and implementation. J Stat Softw. 2007;20:1-24.

52.

Kelley K. Methods for the behavioral, educational, and social sciences: An R package. Behav Res Methods. 2007;39:979-984.PubMedCrossRef

53.

Kelley K, Lai K. MBESS (version 3.2.0) Computer Software and Manual. Available at http://www.cran.r-project.org/.

54.

Ogalha C, Luz E, Sampaio E, et al. A randomized, clinical trial to evaluate the impact of regular physical activity on the quality of life, body morphology and metabolic parameters of patients with AIDS in Salvador, Brazil. J Acquir Immune Defic Syndr. 2011;57:S179-S185.PubMedCrossRef

55.

Bova CA, Fennie KP, Knafl GJ, Dieckhaus KD, Watrous E, Williams AB. Use of electronic monitoring devices to measure antiretroviral adherence: Practical considerations. AIDS Behav. 2005;9:103-110.PubMedCrossRef

56.

Santos-Lozano A, Garatachea N. Physical activity measurements using accelerometers and pedometers in HIV-infected people. J AIDS Clinic Res. 2011;2:126.

57.

Spencer SJ, Zanna MP, Fong GT. Establishing a causal chain: Why experiments are often more effective than mediational analyses in examining psychological processes. J Pers Soc Psychol. 2005;89(6):845-851.PubMedCrossRef

58.

Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423-1434.PubMedCrossRef

59.

Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: The evidence. CMAJ. 2006;174:801-809.PubMed

60.

Safren SA, O’Cleirigh C, Tan JY, et al. A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected individuals. Health Psychol. 2009;28:1-10.PubMedCrossRef

61.

Safren SA, O’Cleirigh CM, Bullis JR, Otto MW, Stein MD, Pollack MH. Cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected injection drug users: A randomized controlled trial. J Consult Clin Psychol. 2012;80:404-415.PubMedCrossRef

62.

Antoni MH, Baggett L, Ironson G, et al. Cognitive-behavioral stress management intervention buffers distress responses and immunologic changes following notifications of HIV-1 seropositivity. J Consult Clin Psychol. 1991;59:906-915.PubMedCrossRef

63.

Penedo FJ, Dahn JR. Exercise and well-being: A review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry. 2005;18:189-193.PubMedCrossRef

64.

Jacobson NS, Martell CR, Dimidjian S. Behavioral activation treatment for depression: Returning to contextual roots. Clin Psychol. 2001;8:255-270.

65.

Lejuez CW, Hopko DR, LePage J, Hopko S, McNeil D. A brief behavioral activation treatment for depression. Cogn Behav Pract. 2001;8:164-175.CrossRef

66.

Lejuez CW, Hopko DR, Acierno R, Daughters SB, Pagoto SL. Ten year revision of the Brief Behavioral Activation Treatment for Depression: Revised treatment manual. Behav Modif. 2011;35:111-161.PubMedCrossRef

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.

68.

Sturmey P. Behavioral activation is an evidence-based treatment for depression. Behav Modif. 2009;33:818-829.PubMedCrossRef

69.

Pagoto S, Bodenlos JS, Schneider KL, Olendzki B, Spates CR, Ma Y. Initial investigation of behavioral activation therapy for comorbid major depressive disorder and obesity. Psychotherapy. 2008;45:410-415.PubMedCrossRef

70.

Daughters SB, Magidson JF, Schuster RM, Safren SA. Act Healthy: A combined cognitive-behavioral depression and medication adherence treatment for HIV-infected substance users. Cogn Behav Pract. 2010;17:309-321.PubMedCrossRef

Titel: Physical Activity and Health Outcomes Among HIV-Infected Men Who Have Sex with Men: A Longitudinal Mediational Analysis
verfasst von: Aaron J. Blashill, Ph.D.
Kenneth H. Mayer, M.D
Heidi Crane, M.D.
Jessica F. Magidson, M.S.
Chris Grasso, M.P.H.
W. Christopher Mathews, M.D., M.S.P.H.
Michael S. Saag, M.D.
Steven A. Safren, Ph.D.
Publikationsdatum: 01.10.2013
Verlag: Springer US
Erschienen in: Annals of Behavioral Medicine / Ausgabe 2/2013
Print ISSN: 0883-6612
Elektronische ISSN: 1532-4796
DOI: https://doi.org/10.1007/s12160-013-9489-3

Neu in den Fachgebieten Neurologie und Psychiatrie

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärzte und Psychotherapeuten.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Physical Activity and Health Outcomes Among HIV-Infected Men Who Have Sex with Men: A Longitudinal Mediational Analysis