Dropout from physical activity interventions in people living with HIV: a systematic review and meta-analysis.

Journal: AIDS care

Volume: 29

Issue: 5

Year of Publication: 2017

Affiliated Institutions:  a Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium. c Butabika National Referral and Mental Health Hospital , Kampala , Uganda. e School of Public Health & Charles Perkins Centre , University of Sydney , Sydney , NSW , Australia. b University Psychiatric Center KU Leuven, KU Leuven - University of Leuven , Leuven-Kortenberg , Belgium. f Centro Universitário La Salle , Canoas , Brazil. g Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil. h Physiotherapy Department , South London and Maudsley NHS Foundation Trust , London , UK.

Abstract summary 

Physical activity (PA) interventions have been shown to improve the health of people living with HIV (PLWH), yet treatment dropout poses an important challenge. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout in PA interventions in PLWH. Electronic databases were searched for records up to September 2016. Randomized control trials of PA interventions in PLWH reporting dropout rates were included. Random effects meta-analysis and meta-regression analyses were employed. In 36 studies involving 49 PA intervention arms, 1128 PLWH were included (mean age = 41.6 years; 79.3% male; 39% White). The trim and fill adjusted treatment dropout rate was 29.3% (95% CI = 24.5-34.7%). There was a significant lower dropout rate in resistance training interventions compared with aerobic (p = 0.003) PA interventions, in studies utilizing supervised interventions throughout the study period (p < 0.001), and in studies using adequately qualified professionals (p < 0.001). Exerciser/participant variables that moderated higher dropout rates were a lower percentage of male participants (β = 1.15, standard error (SE) = 0.49, z = 2.0, p = 0.048), a lower body mass index(BMI) (β = 0.14, SE = 0.06, z = 2.16, p = 0.03), and a lower cardiorespiratory fitness (β = 0.10, SE = 0.04, z = 2.7, p = 0.006). The dropout from PA interventions is much higher in PLWH than in many other populations with chronic morbidities. Qualified professionals (i.e., exercise physiologists, physical educators, or physical therapists) should be incorporated as key care providers in the multidisciplinary care of HIV/AIDS and should prescribe supervised PA for PLWH in order to enhance adherence and reduce the burden of HIV/AIDS. Special attention should be given men, those with a higher BMI, and those with a lower cardiorespiratory fitness.

Authors & Co-authors:  Vancampfort D D Mugisha J J Richards J J De Hert M M Lazzarotto A R AR Schuch F B FB Probst M M Stubbs B B

Study Outcome 

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Statistics
Citations : 
Authors :  8
Identifiers
Doi : 10.1080/09540121.2016.1248347
SSN : 1360-0451
Study Population
Male
Mesh Terms
Body Mass Index
Other Terms
AIDS;HIV;exercise;physical activity
Study Design
Randomized Control Trial,Case Control Trial,Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Publication Country
England