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The impact of a therapeutic exercise intervention on depression and body self-image in HIV-positive women in sub-Saharan Africa

Authors Daniels AK, Van Niekerk RL

Received 1 March 2018

Accepted for publication 27 April 2018

Published 16 July 2018 Volume 2018:10 Pages 133—144

DOI https://doi.org/10.2147/HIV.S167005

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Bassel Sawaya


Video abstract presented by Dr Andrea K Daniels.

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Andrea K Daniels,1 Rudolph L Van Niekerk2

1School of Community Psycho-social Research (COMPRES), Faculty of Health Sciences, North West University, Potchefstroom, South Africa; 2Department of Human Movement Science, Faculty of Health Sciences, University of Fort Hare, Alice, South Africa

Introduction:
Attitudes, responses, and reactions of HIV-positive women in three sub-Saharan African regions toward a therapeutic exercise intervention, aimed to determine the presence of depression and low body self-image, were captured. This provided insight into body satisfaction and desire to exercise (Stage 1, n=60), body self-image and depression (Stage 2, n=60), and overall concerns around the often adverse side effects of antiretroviral treatment (ART). A program of therapeutic (specialty) exercise was developed for the experimental design (Stage 2), to quantify the psychological side effects of these variables.
Methodology: Stage 1 constituted a qualitative exploration into attitudes and perceptions around ART, toxicity, health concerns, metabolic irregularities (lipodystrophy), body shape and size dissatisfaction, and cultural attitudes toward exercise. This stage deployed brief informal face-to-face interviews, based on the World Health Organization (WHO)/United Nations Fund for Population Activities (UNFPA) AIDS Inventory, in three sub-Saharan African regions (including provincial and district hospitals, nongovernmental organizations, voluntary counseling and testing/HIV and testing centers, and primary care outpatient clinics). Stage 2 of the study comprised a quantitative experimental design, conducted on a sample of HIV-positive women (mean age=39.0 years; mean years on ART=5.5; 86% black) in three selected HIV outpatient clinics in Johannesburg, South Africa.
Data analysis: The collated data sets from both stages of the research were presented, analyzed, and interpreted (thematic analyses [Stage 1] and statistical analyses [Stage 2]) using the body self-image questionnaire and Beck’s depression inventory.
Results: Stage 1 outlined participants’ concerns and reports around 1) body shape and size, including long-term effects of ART and 2) attitudes toward exercise, as a function of HIV status. Stage 2 represented pre- and posttest statistics, showing low statistical means for both the experiment and the control groups, with statistical significance for four out of nine items of subscales of body self-image questionnaire.

Keywords: antiretroviral treatment, ART, body self-image, depression, functional cognition, lipodystrophy, therapeutic movement
 

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