Perceptions of physical activity for health promotion among people living with HIV in Uganda: A qualitative study

BackgroundPromoting health and quality of life for people living with HIV (PLHIV) in low-resource settings is vital. Understanding perceptions of physical activity (PA) and factors influencing participation can guide culturally appropriate interventions. This study explored how PLHIV in Central Uganda perceive PA, factors affecting its acceptability, and views on integrating PA into antiretroviral treatment (ART) services.MethodsA qualitative exploratory design was used. Semi-structured interviews were conducted with 12 adults (7 women, 5 men) on ART for at least 1 year. Data were analysed using content analysis, guided by the socio-ecological model.ResultsPerceptions of PA were shaped by intersecting factors across multiple levels. Individual factors included perceived weakness, comorbidities, fear of health risks, low awareness of PA benefits, body image concerns, competing demands, and seasonal food insecurity. Family and community-level barriers included stigma, gender norms, and lack of support. Institutional barriers involved limited health worker engagement and absence of PA-related incentives.ConclusionsReshaping perceptions and improving PA acceptability requires stronger health system involvement. Embedding PA promotion into routine HIV care and engaging health workers can help address barriers across levels. A multi-level public health approach is needed to integrate PA into biopsychosocial HIV care.