A Qualitative Study on Awareness, Perceptions, Facilitators and Barriers to Physical Activity Among People Living with HIV in Mwanza, Tanzania

Background: Physical activity in people living with HIV improves their well-being, has positive psychological effects, and may reduce the side effects of antiretroviral therapy. However, biological factors of HIV infection, social and cultural norms, including lack of facilities and resources, limited awareness, and different perceptions of physical activity, can be the facilitators or barriers to physical activity. This study explored holistically perceptions, facilitators, and barriers to physical activity among people living with HIV in an African context.

Methods: This descriptive qualitative study was nested in a cohort study among HIV-infected participants in the Mwanza region. Sixteen In-Depth Interviews and three Focus Group Discussions were conducted between August-November 2019. Purposively sampling by sex, age above 18 years, and being HIV –positive was used to select respondents from the CICADA cohort. Transcripts were coded and analyzed using Thematic-content analysis.

Results: Findings confirmed people living with HIV (PLWH) have differing perceptions and awareness of physical activity. Some respondents felt that house chores and income-generating activities that involved walking long distances like selling vegetables were enough exercise for them. However, mixed feelings of fear and decisions not to do exercises because of the belief that the HIV disease will worsen were also reported. Family and friends' encouragements to PLWH to participate in exercises were observed despite gender differences in perceptions and practices. Findings also confirmed that PLWH has well-established support and advice on living a healthier lifestyle and ART services from health professionals. Still, little or no information was provided on the importance of physical activity.

Conclusion: The findings demonstrated differing awareness perceptions, experiences, facilitators, and physical activity barriers at individual to community levels. Programs addressing holistically physical activity knowledge and practices at different groups in the community will escalate physical activity levels, including in PLWH.