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Heart Health and Behavior Change in HIV-Infected Individuals

John M Abbamonte1, Nicholas V Cristofari1, Stephen M Weiss1

  • 1Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Dominion Towers Suite 404A, 1400 NW 10th Avenue, Miami, FL, 33136, USA.

AIDS and Behavior
|September 6, 2020
PubMed

Insights

Cardiovascular disease risk behaviors like diet and exercise were resistant to change in HIV-infected and cocaine-using individuals, despite standard care interventions. Arterial plaque increased over two years, indicating limited impact on disease progression.

Area of Science:

  • Cardiology
  • Public Health
  • Infectious Diseases

Background:

  • Cardiovascular disease (CVD) risk management necessitates lifestyle modifications including diet, smoking cessation, and exercise.
  • Individuals diagnosed with arterial plaque are advised to adopt these changes for improved longevity.
  • The study focuses on behavioral changes in response to standard care interventions among HIV-infected individuals who use cocaine.

Purpose of the Study:

  • To examine behavioral changes in response to standard of care after arterial plaque detection.
  • To assess lifestyle and physiological outcomes in HIV-infected and/or cocaine-using individuals one and two years post-intervention.
  • To determine the effectiveness of standard care in modifying CVD risk factors in this population.

Main Methods:

  • A cohort of 127 individuals was categorized based on HIV and cocaine use status (HIV-COC, HIV+COC-, HIV+COC+, HIV-COC+).
  • Participants received standard of care for cardiovascular risk reduction.
  • Lifestyle (diet, exercise, smoking) and physiological (blood pressure, BMI, arterial plaque) outcomes were assessed at baseline, 1 year, and 2 years post-intervention.

Main Results:

  • Arterial plaque was observed to increase over the two-year study period (b=0.003, SE=0.002, p=0.031).
  • A composite measure of cardiovascular disease risk did not significantly change (b=-0.004, SE=0.01, p=0.548).
  • Key health behaviors related to CVD risk remained resistant to change in both HIV-infected and uninfected, and cocaine-using and non-using participants.

Conclusions:

  • Standard of care cardiovascular risk reduction interventions showed limited effectiveness in promoting significant lifestyle changes.
  • Both HIV-infected and cocaine-using individuals demonstrated resistance to adopting recommended health behaviors.
  • Arterial plaque progression and lack of change in composite CVD risk suggest a need for more intensive or tailored interventions for this population.

Keywords:
CocaineHIVHealth behaviorsHeart diseaseSmoking

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