Impact of Perceived Cardiovascular Risk on Cardiovascular Disease Prevention Behaviors in People With and Without HIV Infection
Impact of Perceived Cardiovascular Risk on Cardiovascular Disease Prevention Behaviors in People With and Without HIV Infection
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DOI：
10.1097/qai.0000000000002290
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发表时间：
2020-04-15
影响因子：
3.6
通讯作者：
Longenecker, Chris T.
中科院分区：
文献类型：
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作者：
Webel, Allison;Davey, Christine Horvat;Longenecker, Chris T.
背景：HIV感染者（PLHIV）发生动脉粥样硬化性心血管疾病（ASCVD）的风险升高。PLHIV不参与建议的ASCVD预防行为水平，可能是由于对ASCVD风险的感知降低。我们研究了艾滋病毒感染状况如何影响ASCVD和ASCVD预防行为的知识，信念和风险感知。方法和结果：我们对191名艾滋病毒感染者和人口统计学上相似的未感染艾滋病毒的成年人进行了混合方法研究。参与者完成了关于心血管疾病风险认知、心血管疾病药物（阿司匹林、降压药和降脂药）依从性的自我报告调查和3次饮食摄入访谈。所有人都戴着一个加速计来测量身体活动。PLHIV的一个子集（n = 38）也完成了定性焦点小组，以进一步研究艾滋病毒对知识的影响，ASCVD的风险感知和行为。参会人员：他们大约54（+/- 10）岁，大多数是男性（n = 111; 58%）和非洲裔美国人（n = 151，83%），ASCVD事件的平均10年风险为10.4（+/- 8.2）%。艾滋病病毒感染者不太可能从事体力活动（44%对65%，P < 0.05），艾滋病病毒感染者每周减少43分钟的体力活动（P = 0.004）。艾滋病病毒感染者对ASCVD药物治疗的依从性较好（P < 0.001）。各组的饲料组成相似（P > 0.05）。HIV感染状况不影响ASCVD风险认知（P > 0.05），但对体力活动和吸烟有一定影响。结论：虽然ASCVD风险的看法适度影响一些行为，额外的障碍和行动线索不足导致次优的体力活动，饮食摄入量和吸烟率。然而，PLHIV对ASCVD药物的依从性很高，可以利用这些药物来减轻ASCVD的高负担。
Background: People living with HIV (PLHIV) are at elevated risk of developing atherosclerotic cardiovascular disease (ASCVD). PLHIV do not engage in recommended levels of ASCVD prevention behaviors, perhaps due to a reduced perception of risk for ASCVD. We examined how HIV status influences knowledge, beliefs, and perception of risk for ASCVD and ASCVD prevention behaviors. Methods and Results: We conducted a mixed-methods study of 191 PLHIV and demographically similar HIV-uninfected adults. Participants completed self-reported surveys on CVD risk perceptions, adherence to CVD medication (aspirin, antihypertensives, and lipid-lowering medication) and 3 dietary intake interviews. All wore an accelerometer to measure physical activity. A subset of PLHIV (n = 38) also completed qualitative focus groups to further examine the influence of HIV on knowledge, perception of risk for ASCVD, and behavior. Participants: They were approximately 54 (+/- 10) years, mostly men (n = 111; 58%), and African American (n = 151, 83%) with an average 10-year risk of an ASCVD event of 10.4 (+/- 8.2)%. PLHIV were less likely to engage in physical activity (44% vs 65%, P < 0.05), and HIV status was associated with 43 fewer minutes of physical activity per week (P = 0.004). Adherence to ASCVD medications was better among PLHIV (P < 0.001). Diet composition was similar between groups (P > 0.05). HIV status did not influence ASCVD risk perceptions (P > 0.05) and modestly influenced physical activity and smoking. Conclusions: Although perceptions of ASCVD risk modestly influence some behaviors, additional barriers and insufficient cues to action result in suboptimal physical activity, dietary intake, and smoking rates. However, PLHIV have high adherence to ASCVD medications, which can be harnessed to reduce their high burden of ASCVD.