Impact of Physical Activity and Diet on Symptom Experience in People Living With HIV

PROSPER-HIV is a four-year, prospective, observational study of 850 CNICS participants who
will complete an enhanced patient-reported outcome (PRO) assessment to measure physical
activity and diet intake, once a year for three years. All participants will also complete
the standard CNICS PRO and clinical assessment procedures. We propose to integrate the
following measures, physical activity (triaxial accelerometery), dietary intake (24-hour diet
recalls), and anthropomorphic factors (waist-hip-ratio), into an enhanced annual assessment
of patient reported outcomes at four CNICS sites: Case Western Reserve University, University
of Alabama at Birmingham, University of Washington, and Fenway Health. Our four primary
objectives are to:

1. Identify and characterize longitudinal, objectively measured, physical activity and
dietary patterns among PLHIV

2. Examine the relationship between objectively-measured physical activity and
self-reported physical activity on the Lipid Research Clinics Physical Activity
Questionnaire.

3. Determine which aspects of physical activity patterns and diet quality are associated
with decreased symptom burden and intensity in PLHIV, and if this relationship is
moderated by age and sex.

4. Explore the potential mediating effect of anthropomorphic and physical fitness variables
on the relationships between physical activity, dietary patterns, and symptom burden and
intensity in PLHIV.

We hypothesize that people living with HIV who 1) have more intense, frequent and longer
physical activity bouts will have age- and sex-dependent reduced symptom burden; 2) eat
better quality diets (e.g., more fiber and protein, fewer carbohydrates) will have reduced
symptom burden and intensity and that this relationship will also vary by age and sex.

Inclusion Criteria:

1. Be an active CNICS participant

2. aged ≥18 years

3. prescribed HIV antiretroviral therapy, and

4. have an undetectable HIV viral load: defined as the most recent HIV viral load <200
copies/mL, checked within the past year.

Exclusion Criteria:

1) Did not complete the HIV Symptom Index in the PRO assessment (2) No reliable access to a
telephone or internet-enable telephone services needed to complete the 24-diet recalls (3)
Was pregnant, breast-feeding, or planning a pregnancy at the time of PRO assessment (4)
Planning to move out of the area in the next 36 months, or (5) Non-English speaking.