Exercise Interventions Conducted Among Individuals with Co-occurring HIV and Unhealthy Substance Use: A Systematic...

Area of Science:

• Public Health
• Exercise Science
• HIV/AIDS Research

Background:

• Unhealthy substance use and physical inactivity are significant co-occurring risk factors for morbidity and mortality in people with HIV (PWH).
• Limited evidence-based exercise interventions exist that target both risk factors simultaneously in PWH.

Purpose of the Study:

• To systematically review existing literature on exercise interventions for PWH with unhealthy substance use.
• To assess the effectiveness and feasibility of these interventions on various health outcomes.

Main Methods:

• A comprehensive literature search was conducted across seven databases for relevant articles published up to May 7, 2024.
• Included studies were randomized controlled trials (RCTs) or quasi-experimental designs involving PWH (≥18 years) with unhealthy substance use and an exercise component.
• Data extraction and quality appraisal were performed independently by two researchers using standardized tools (Cochrane Data Collection Form, Joanna Briggs Institute Critical Appraisal Tool).

Main Results:

• Seven studies (6 pilot RCTs, 1 quasi-experimental) met the inclusion criteria, primarily conducted in the US, with small sample sizes (16-73 participants).
• Interventions included supervised training, home-based programs with virtual counseling, yoga, and tai-chi combined with cognitive behavioral therapy, delivered 1x/week for 6-24 weeks.
• Despite heterogeneity, exercise interventions were significantly associated (p < 0.05) with improvements in HIV status, substance use, physical activity levels, strength/fall risk, quality of life/stress, and pain relief.

Conclusions:

• All reviewed studies were of high quality, demonstrating low risk of bias, safety, and feasibility.
• Evidence supports the use of exercise interventions to enhance multiple health outcomes for PWH experiencing unhealthy substance use.
• Further research with larger sample sizes is warranted to confirm these findings due to study heterogeneity.