Predictors of exercise stage of change among individuals living with HIV/AIDS

Protocol for WeExPAnd: a prospective, mixed-methods pilot demonstration study to increase access to pre-exposure prophylaxis among women vulnerable to HIV infection in the Southern USA

INTRODUCTION

African American women (AA), particularly those living in the Southeastern USA, experience disproportionately high rates of HIV infection. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool that may circumvent barriers to traditional HIV prevention tools, such as condom use; however, very little is known about how to improve PrEP access and uptake among AA women who may benefit from PrEP use. This project aims to understand how to increase PrEP access among AA women in the rural Southern USA, which may ultimately affect HIV incidence in this population.

METHODS AND ANALYSIS

The goal of the current study is to systematically adapt a patient-provider communication tool to increase PrEP uptake among AA women receiving care at a federally qualified health centre in Alabama. We will use an iterative implementation process, by assessing the feasibility, acceptability and preliminary impact of the tool on PrEP uptake, using a pilot preintervention/postintervention design (N=125). We will evaluate women's reasons for declining a referral to a PrEP provider, reasons for incomplete referrals, reasons for not initiating PrEP after a successful referral and ongoing PrEP use at 3 and 12 months after PrEP initiation among our sample. The proposed work will significantly contribute to our understanding of factors impacting PrEP uptake and use among AA women, particularly in underserved areas in the Deep South that are heavily impacted by the HIV epidemic and experience worse HIV-related health outcomes relative to other areas in the USA.

ETHICS AND DISSEMINATION

This protocol has been approved by the Institutional Review Board (IRB) at University of Alabama at Birmingham (Birmingham, AL; protocol 300004276). All participants will review a detailed informed consent form approved by the IRB and will provide written or verbal informed consent prior to enrolment. Results will be disseminated through peer-reviewed manuscripts, reports, and local, national and international presentations.

TRIAL REGISTRATION NUMBER

NCT04373551.

Experiences participating in a community-based exercise programme from the perspective of people living with HIV: a qualitative study

OBJECTIVES

Our aim was to explore the experiences of engaging in a community-based exercise programme (CBEP) from the perspective of people living with HIV (PLWH).

DESIGN

We conducted a descriptive qualitative study using semistructured interviews.

SETTING

We recruited adults living with HIV who participated in a 16-week CBEP in Toronto, Canada.

PARTICIPANTS

11 participants, the majority men (64%), with a median age of 52 years, and living with a median of 5 concurrent health conditions in addition to HIV participated in the study.

OUTCOME MEASURES

We asked participants about their overall experiences: strengths, limitations and perceived benefits of the CBEP; factors influencing participation and current level of exercise after completion of the CBEP. We administered a self-reported demographic questionnaire followed by the Rapid Assessment of Physical Activity (RAPA) questionnaire. We analysed interview data using thematic analysis.

RESULTS

We developed a framework that describes the experiences before, during and after the CBEP; and the perceived impact of the CBEP on health, which influenced the intent to, engagement in and sustainability of exercise among PLWH. Participants described the positive impact of the CBEP on their physical, mental and social health. Interviews were completed at a median of 6 months after the CBEP, when 9 participants reported ongoing engagement in exercise, but to a lesser extent than during the CBEP. Intrinsic and extrinsic factors facilitated or hindered engagement in exercise throughout all phases of the CBEP. The episodic nature of HIV and multimorbidity influenced engagement in exercise and posed challenges to re-engagement after periods of inactivity.

CONCLUSIONS

CBEPs provide an opportunity to enhance physical activity, perceived health outcomes and knowledge about exercise for PLWH. Community-based exercise is a strategy that may be used by health providers to promote engagement in sustained physical activity for PLWH.

The relationship of knowledge, health value and health self-efficacy with men's intentions to receive the human papillomavirus (HPV) vaccine

The aim of the present study was to determine whether it was possible to predict Human Papillomavirus (HPV) vaccination intentions an Australian male sample. One hundred and twenty one males aged 18 to 26 (M = 22.3, SD = 2.06), completed an online survey assessing HPV-related knowledge, health beliefs and health self-efficacy. HPV knowledge and health self-efficacy were significant independent predictors of vaccine acceptance. A moderating effect was found between HPV knowledge and health self-efficacy. It was concluded that the results of previous research into the predictors of HPV vaccination intentions can largely be applied to an Australian male population.