Increasing physical activity among persons living with HIV engaged in unhealthy drinking

项目概要/摘要 抗逆转录病毒疗法的时代显示，预期寿命增加，与艾滋病毒有关的死亡减少， 导致老年艾滋病毒感染者不断增加。然而，艾滋病毒加速了衰老过程，并增加了 许多慢性健康状况损害身心健康功能。此外，在此 在这种情况下，不健康的酒精使用在艾滋病毒感染者（PLWH）中很常见，也会增加感染艾滋病毒的风险。 消极的结果。然而，针对艾滋病毒携带者不健康饮酒问题的干预措施很少， 导致了显著的影响，也没有采用可能影响这些多发病的方法。 因此，可能对艾滋病病毒携带者不健康饮酒产生重大影响的干预方法是 必要的，特别是如果他们也有可能影响身体和精神健康的多病 在PLWH中常见。努力解决PWLH中另一种高度流行的疾病-身体 不活动和久坐不动，可能有利于改变不健康的饮酒和身体和精神 健康功能。到目前为止，PLWH的体力活动（PA）方法主要包括结构化， 有监督的，以健身房为基础的干预措施，已经产生了积极的结果，但在他们的 与这一人群的高辍学率有关。在这里，我们提出了一个替代范例-家- 基于生活方式的体力活动（LPA），具有移动的健康交付组件， 解决了以前方法的现有局限性。LPA干预措施包括行为策略， 指导个人将间歇性PA整合到日常生活中。LPA的额外优势 方法是它可能是非常适合PLWH从事不健康的饮酒，通过提供累积的身体 和心理健康的影响，从定期，每天PA以及急性影响的负面影响（常见的 PLWH从事不健康的饮酒），并通过个人的，短暂的活动来饮酒。迄今为止， 尚未在艾滋病毒携带者中测试干预措施。因此，我们会透过网上招募艾滋病毒携带者， HIV+不健康饮酒者，并将他们随机分配到12周的LPA+Fitbit干预或仅Fitbit干预 条件主要结果将包括饮酒/饮酒日和在结束时客观确定的步数/日 治疗和6个月的随访。生理和心理健康状况之间的变化， 酒精相关的问题，应对，PA动机和PA自我效能将作为次要因素进行检查 成果。此外，为了阐明干预效应的机制，我们将采用两个生态突发事件， 瞬时评估，以获得多种日常情绪指标，饮酒欲望，饮酒量， 公共行政参与加上对公共行政的客观评估。如果LPA+Fitbit干预被证明是有效的， 使用移动的健康技术的生活方式方法将直接影响这一高危人群的显著多发病率。 艾滋病毒/艾滋病感染者从事不健康的饮酒，这反过来可能会对公共卫生产生重大影响。

PROJECT SUMMARY/ABSTRACT The era of antiretroviral therapy has shown increasing life expectancy and decreased HIV-related deaths, leading to a growing older adult HIV population. Yet, HIV accelerates the aging process and increases risk for numerous chronic health conditions that compromise physical and mental health functioning. Further, in this context, unhealthy alcohol use is common among persons living with HIV (PLWH) and also increases risk for negative outcomes. Yet, there are few interventions to address unhealthy alcohol use in PLWH that have resulted in significant effects nor have they employed approaches that could impact these multimorbidities. Therefore, intervention approaches that may have significant impact on unhealthy drinking in PLWH are necessary, particularly if they also have the potential to affect the physical and mental health multimorbidities common in PLWH. Efforts toward addressing another highly prevalent condition among PWLH – physical inactivity and sedentariness, may prove beneficial for changing unhealthy drinking and physical and mental health functioning. To date, physical activity (PA) approaches in PLWH have primarily consisted of structured, supervised, gym-based interventions that have resulted in positive outcomes but have been limited in their reach and associated with high drop-out in this population. Here we propose an alternate paradigm – home- based, lifestyle physical activity (LPA) with mobile health-delivered components that have the potential to address existing limitations of previous approaches. LPA interventions consist of behavioral strategies that guide individuals to integrate intermittent bouts of PA in their daily routines. An added strength of the LPA approach is it may be well-suited for PLWH engaged in unhealthy drinking by providing cumulative physical and mental health effects from regular, daily PA as well as acute effects on negative affect (common among PLWH engaged in unhealthy drinking) and urges to drink via individual, brief bouts of activity. To date, LPA interventions have not been tested in PLWH. As such, through online recruitment of PLWH, we will identify 220 HIV+ unhealthy drinkers and randomize them to the 12-week LPA+Fitbit intervention or to a Fitbit Only condition. Primary outcomes will include drinks/drinking day and objectively-determined steps/day at end of treatment and 6-month follow-ups. Changes between conditions on physical and mental health functioning, alcohol-related problems, coping, PA motivation, and PA self-efficacy will be examined as secondary outcomes. In addition, to elucidate mechanisms of intervention effects, we will employ two bursts of ecological momentary assessment to obtain multiple daily measures of affect, urges to drink, alcohol consumption, and PA engagement coupled with objective assessment of PA. If the LPA+Fitbit intervention proves efficacious, our lifestyle approach using mobile health technology will directly affect the significant multimorbidity in this at-risk population of PLWH engaged in unhealthy drinking, which in turn may have significant public health impact.