A wellness intervention to address weight gain in people living with HIV

BACKGROUND: Dolutegravir-based antiretrovirals are the cornerstone of HIV treatment in LMICs but has shown to be associated with excessive (≥10%) weight gain. Increased body mass index combined with fat redistribution poses increased risk for diabetes, hypertension, and cardiovascular disease. The South African Diabetes Prevention Program (SA-DPP) is a lifestyle intervention program, including nutrition education, physical activity, and other risky behaviors and has been adapted to poorly resourced communities in Cape Town. We aimed to adapt the SA-DPP intervention for people living with HIV (PLWH) and assess its acceptability and feasibility. METHODS: PLWH and health staff were drawn from three primary health clinics in Cape Town (n = 35). Purposive sampling was used. Five focus groups (FG) with PLWH; two individual interviews (II) with PLWH; five interviews with health staff, including two II with medical doctors; two with a pair of nurses each and a group of three lay counsellors and three II with experts on diet and exercise lifestyle (n = 6). The FG and interviews explored two parts 1) PLWH experience of HIV treatment, their lifestyle issues, the education and support received from clinics and 2) review, evaluation and perspectives on the current SA-DPP intervention and tools. FG and interviews were transcribed and thematically analyzed. RESULTS: The SA-DPP curriculum was positively reviewed by PLWH and health staff. This included acceptability of the content and structure of the material. The content was deemed thorough and detailed in relation to nutrition and exercise. “The physical active part here, is something that I need in my life, this is something that I need in my health, the improve your sleep and the stress”. Practical in its approach, gave options within reach, in terms of availability and cost. CONCLUSIONS: The intervention content was deemed accessible and covered all important areas. Experts thought it a resource PLWH could use over time and across illnesses. KEY MESSAGES: • This study provides insight into the challenges faced by PLWH in trying to live a healthier lifestyle. • The result of this study will translate into a healthy lifestyle intervention that can easily be adopted in the current primary health care set up for PLWH.