Publications
Perspectives of people living with HIV on ART-related weight change and healthy weight
2023
Kaufman, J.E., Wu, Y., Manalel, J., Fusaris, E., Correa, A., Ernst, J., Brennan-Ing, M. (2023, July 24-26). Perspectives of people living with HIV on ART-related weight change and healthy weight [E-poster presentation]. International AIDS Society conference (IAS 2023), Brisbane, Australia. https://programme.ias2023.org/Abstract/Abstract/?abstractid=3185
Jennie Kaufman, Yiyi Wu, Jasmine Manalel and Mark Brennan-Ing
Abstract
Background: Newer HIV antiretroviral therapy (ART) regimens are associated with greater weight gain compared with older regimens, but myriad factors affect weight change among people living with HIV (PLWH). This qualitative study examined how PLWH experience weight change in their daily lives, how they feel about their body image, and how that influences health behaviors, including ART adherence.
Methods: PLWH were recruited through Amida Care, a Medicaid managed care organization in New York City, and screened to ensure a diverse sample (N=61). Half the participants (51%) were cisgender men (71% gay/bisexual), 36% were cisgender women (9% lesbian/bisexual), and 13% were transgender/nonbinary individuals; 87% were Black and/or Hispanic. Ages ranged from 23 to 65; 49% of the sample were over 50. Semi-structured interviews were conducted by phone during fall 2021. Topics included participants’ stories of weight changes, if any, particularly in relation to HIV disease or ART initiation and switches; perspectives on healthy weight; and approaches to self-care. Interviews were inductively analyzed to identify themes using a constructivist grounded theory approach.
Results: Many participants had gained weight since their HIV diagnosis. Some, especially long-term HIV survivors, interpreted “weight change” as referring to lipodystrophy. Many attributed weight change at least partly to ART initiating or switching. Other cited causes were eating habits, lack of exercise (exacerbated by the COVID pandemic), other medications, attaining sobriety, or depression and anxiety. Body image satisfaction varied widely across the sample. Some seemed to have responded to the HIV diagnosis by focusing on healthful habits, but others struggled with weight and other health issues, including ART adherence.
Conclusions: Our findings suggest that some PLWH may grapple with a loss of control in terms of managing weight and weight change, whether or not they attribute the changes to ART. Achieving and maintaining viral suppression is the priority, but for many participants HIV treatment was associated with health and body image problems they felt forced to accept. These perspectives can help health care providers counsel and support PLWH in maintaining viral suppression and healthy weight by elucidating PLWH’s challenges and concerns associated with ART and weight change.