“Not easy at all but I am trying”: barriers and facilitators to physical activity in a South African cohort of people living with HIV participating in a home-based pedometer walking programme

Abstract

The promotion of physical activity is encouraged in people living with HIV and AIDS (PLWHA) as a means of promoting wellness and health. Adherence to programmes that promote exercise is often reduced, and home-based programmes are suggested to improve adherence. This study investigated the personal and environmental factors that cause barriers and facilitators of physical activity in a home-based pedometer walking programme as a means of highlighting adherence challenges. An observational study nested in a randomised controlled trial was conducted in a cohort of South African PLWHA on antiretroviral therapy over a six-month period. Descriptive analysis and qualitative content analysis of 42 participants who underwent physical activity modification assisted with data review. The mean age of the sample was 38.7 (±8.9) years, consisted mostly of women (n = 35; 83.3%) who were employed (n = 19; 45.2%) but earning very little (less than R500 per month) and often single or widowed (n = 23; 54.8%). Barriers to physical activity identified included physical complaints, e.g., low-energy levels; psychological complaints, e.g., stress levels; family responsibility, e.g., being primary caregivers; the physical environment, e.g., adverse weather conditions; social environment, e.g., domestic abuse and crime; and workplace, e.g., being in a sedentary job. Facilitators of physical activity included support and encouragement from friends and family, religious practices during worship and community environment, e.g., having access to parks and sport fields. The study is of benefit as it highlights personal and environmental factors that need to be considered when developing or implementing a home-based walking programme in PLWHA.

Keywords:

• physical activity
• adherence
• HIV

Acknowledgement

This study was possible due to the support from Themba Lethu HIV clinic, Clinical HIV Research Unit, Right to Care and the Department of Medicine at Helen Joseph Hospital in Gauteng, South Africa.

Funding

This work was supported by the National Research Foundation Thuthuka Programme [grant number 76280]; National Research Foundation Sabbatical Grant to Complete Doctoral Degrees [grant number 86485]; University of the Witwatersrand, Faculty Research Committee Grants [grant number 4759]; Medical Research Council Self-Initiated Research Grant [grant number MZWA012]; South African Society of Physiotherapy, Research Foundation Grant. “Any opinion, findings and conclusions or recommendations expressed in this material are those of the author(s) and therefore the NRF or MRC does not accept any liability in regard thereto”.

Additional information

Funding

Funding: This work was supported by the National Research Foundation Thuthuka Programme [grant number 76280]; National Research Foundation Sabbatical Grant to Complete Doctoral Degrees [grant number 86485]; University of the Witwatersrand, Faculty Research Committee Grants [grant number 4759]; Medical Research Council Self-Initiated Research Grant [grant number MZWA012]; South African Society of Physiotherapy, Research Foundation Grant. “Any opinion, findings and conclusions or recommendations expressed in this material are those of the author(s) and therefore the NRF or MRC does not accept any liability in regard thereto”.