Objectively Measured Physical Activity among People with and without HIV in Uganda: Associations with Cardiovascular Risk and Coronary Artery Disease

Chinonso C. Opara; Christine Horvat Davey; Cissy Kityo; Ellen Brinza; Rashidah Nazzinda; Marcio Summer Bittencourt; Vitor Oliveira; Allison R. Webel; Chris T. Longenecker

doi:10.5334/gh.1398

Objectively Measured Physical Activity among People with and without HIV in Uganda: Associations with Cardiovascular Risk and Coronary Artery Disease

Volume 20 (2025): Issue 1

By: Chinonso C. Opara , Christine Horvat Davey , Cissy Kityo , Ellen Brinza , Rashidah Nazzinda , Marcio Summer Bittencourt , Vitor Oliveira , Allison R. Webel and Chris T. Longenecker

Open Access

|Feb 2025

Figures & Tables

Derivation of the study population from the mUTIMA-CT cohort. Definitions: PLHIV, people living with HIV; CTA, computed tomography angiography; eGFR, estimated glomerular filtration rate.

Table 1

Baseline demographic and clinical characteristics, stratified by HIV status and sex.

	PLHIV MALE N = 32	HIV (+) FEMALE N = 48	PWOH MALE N = 29	HIV (–) FEMALE N = 59
Age in years, median (IQR)	55.00 (51.50, 62.25)	56.50 (53.00, 62.00)	60.00 (51.00, 62.00)	58.00 (55.00, 63.50)
Diabetes, (%)	9 (28.1)	14 (29.2)	17 (58.6)	22 (37.3)
Hypertension, (%)	26 (81.2)	43 (89.6)	23 (79.3)	56 (94.9)
Smoking status, (%)
Smoke every day	1 (3.1)	0 (0.0)	1 (3.4)	0 (0.0)
Smoke, not every day	2 (6.2)	0 (0.0)	0 (0.0)	0 (0.0)
No smoking	29 (90.6)	48 (100.0)	28 (96.6)	59 (100.0)
Alcohol use frequency, (%)
Never	20 (62.5)	41 (89.1)	17 (60.7)	44 (78.6)
Monthly or less	9 (28.1)	3 (6.5)	3 (10.7)	8 (14.3)
2–4 times per month	0 (0.0)	1 (2.2)	5 (17.9)	2 (3.6)
2–3 times per week	2 (6.2)	0 (0.0)	3 (10.7)	0 (0.0)
4 or more times per week	1 (3.1)	1 (2.2)	0 (0.0)	2 (3.6)
Alcohol drinks per use, (%)
1 or 2	8 (66.7)	4 (66.7)	5 (45.5)	11 (84.6)
3 or 4	4 (33.3)	1 (16.7)	5 (45.5)	2 (15.4)
5 or 6	0 (0.0)	1 (16.7)	1 (9.1)	0 (0.0)
Systolic blood pressure, median (IQR)	153 (142, 171)	146 (128, 161)	155 (132, 171)	144 (132, 163)
ASCVD 10-year risk score, median (IQR)	11 [7, 21)	5 (3, 8)	17 (11, 24.83)	6 (3, 12)
Total cholesterol, median (IQR)	201 (1651, 235)	214 (182, 242)	194 ([167, 218)	195 (180, 233)
Body mass index, median (IQR)	24 [22, 27)	28 (25, 33)	28 (24, 31)	33 (30, 34)
Waist hip ratio, median (IQR)	0.93 (0.91, 0.98)	0.88 (0.83, 0.92)	0.94 (0.88, 0.97)	0.86 (0.81, 0.91)
Years with HIV, median (IQR)	14.02 (12.26, 15.92)	13.97 (11.97, 4.54)	–	–
Years with ART, median (IQR)	12.74 (10.73, 14.71)	12.41 (9.80, 14.00	–	–
HIV viral load suppressed, (%)	30 (93.8)	37 (77.1)	–	–
Viral load if not suppressed, %
21–500	1 (3.1)	9 (18.8)	–	–
501–1,000	0 (0.0)	0 (0.0)	–	–
>1,000	1 (3.1)	2 (4.2)	–	–

[i] Definitions: IQR, interquartile range; ART, antiretroviral therapy; ASCVD, atherosclerotic cardiovascular disease risk.

Table 2

Objectively measured physical activity stratified by (a) HIV status and (b) sex.

(A). STRATIFIED BY HIV STATUS
	PLHIV, n = 80	PWOH, n = 88	P-VALUE
Valid wear days, median (IQR)	6.00 (6.00, 7.00)	6.00 (5.75, 7.00)	0.993
Total step counts per day, median (IQR)	5,859.05 (4,308.05, 7,735.14)	5,814.08 (4,027.48, 7,556.35)	0.574
Light activity time per week in minutes, median (IQR)	949.08 (666.87, 1,369.08)	934.00 (649.03, 1,342.00)	0.881
Moderate-to-vigorous activity time per week in minutes, median (IQR)	18.38 (0.00, 95.88)	35.50 (0.00, 74.31)	0.889
Sedentary time per week in minutes, median (IQR)	1,234.50 (951.56, 1,806.58)	1,301.00 (883.31, 1,959.13)	0.906
Achieved 150 minutes moderate-to-vigorous activity or more per week, (%)	11 (13.8)	7 (8.0)	0.335
Achieved 10 thousand steps or more per day, %)	9 (11.2)	6 (6.8)	0.462
(B). STRATIFIED BY SEX
	MALE, n = 61	FEMALE, n = 107	P-VALUE
Valid wear days, median (IQR)	6.00 (6.00, 7.00)	6.00 (6.00, 7.00)	0.757
Total step counts per day, median (IQR)	6,534.00 (5,073.00, 9,177.50)	5,382.33 (3,807.58, 7,316.42)	0.005
Light activity time per week in minutes, median (IQR)	788.00 (497.00, 1,201.67)	1,059.00 (730.40, 1,490.42)	0.001
Moderate-to-vigorous activity time per week in minutes, median (IQR)	68.00 (11.67, 143.50)	15.17 (0.00, 49.50)	<0.001
Sedentary time per week in minutes, median (IQR)	1,320.67 (1,079.17, 1,850.33)	1,203.00 (873.25, 1,916.83)	0.303
Achieved 150 minutes moderate-to-vigorous activity or more per week, (%)	13 (21.3)	5 (4.7)	0.002
Achieved 10 thousand steps or more per day, %)	10 (16.4)	5 (4.7)	0.023

[i] Definitions: IQR, interquartile range; PLHIV, people living with HIV; PWOH, people without HIV.

Table 3

Unadjusted and adjusted associations of objective physical activity metrics with ASCVD 10-year risk ≥ 5%, n = 168.

	UNADJUSTED		ADJUSTED
	PR (95% CI)	P-VALUE	PR	P-VALUE
Total step counts per day ≥ 5.9 thousand	0.954 (0.770–1.181)	0.663	1.042 (0.850–1.277)	0.694
Light activity time per week ≥ 15.7 hours	0.807 (0.649–1.002)	0.053	0.991 (0.821–1.195)	0.922
Moderate-to-vigorous activity time per week ≥ 0.4 hours	0.909 (0.734–1.126)	0.383	0.934 (0.770–1.134)	0.491
Sedentary time per week ≥ 21 hours	1.049 (.847–1.299)	0.663	0.864 (0.714–1.045)	0.131

[i] Definitions: ASCVD, atherosclerotic cardiovascular disease risk; PR, prevalence ratio; CI, confidence interval. Adjusted for age and sex.

Table 4

Unadjusted and adjusted associations of objective physical activity metrics with presence of CTA-detected CAD for (a) the overall cohort with available CTA, stratified by HIV status [(b) and (c)] and by sex [(d) and (e)].

(A) PARTICIPANTS WITH AVAILABLE CTA, N = 139
	UNADJUSTED		ADJUSTED
	PR (95% CI)	P-VALUE	PR	P-VALUE	P_i
Total step counts per day ≥ 5.9 thousand	0.904 (0.467–1.752)	0.765	1.699 (0.854–3.381)	0.131	-
Light activity time per week ≥ 15.7 hours	0.878 (0.453–1.702)	0.701	1.459 (0.691–3.079)	0.322	-
Moderate-to-vigorous activity time per week ≥ 0.4 hours	0.678 (0.347–1.326)	0.256	0.957 (0.534–1.717)	0.883	-
Sedentary time per week ≥ 21 hours	1.240 (0.638–2.409)	0.526	0.715 (0.364–1.406)	0.331	-
(B) STRATIFICATION BY HIV STATUS, UNADJUSTED
	PLWH, n = 64		PWOH, n = 75
	PR (95% CI)	P-VALUE	PR (95% CI)	P-VALUE	*P_i*
Total step counts per day ≥ 5.9 thousand	0.778 (0.213–2.839)	0.704	1.027 (0.485–2.176)	0.945	0.162
Light activity time per week ≥ 15.7 hours	0.259 (0.057–1.188)	0.082	1.461 (0.657–3.160)	0.336	0.025
Moderate-to-vigorous activity time per week ≥ 0.4 hours	0.939 (0.257–3.434)	0.925	0.583 (0.270–1.261)	0.171	0.137
Sedentary time per week ≥ 21 hours	2.012 (0.525–7.713)	0.308	0.974 (0.460–2.063)	0.945	0.121
(C) STRATIFICATION BY HIV STATUS, ADJUSTED
	PLWH, n = 64		PWOH, n = 75
	PR (95% CI)	P-VALUE	PR (95% CI)	P-VALUE	*P_i*
Total step counts per day ≥ 5.9 thousand	1.151 (0.296–4.472)	0.840	2.332 (1.031–5.277)	0.042	0.332
Light activity time per week ≥ 15.7 hours	0.300 (0.068–1.323)	0.112	2.436 (1.019–5.824)	0.045	0.192
Moderate-to-vigorous activity time per week ≥ 0.4 hours	1.110 (0.324–3.802)	0.868	1.130 (0.572–2.232)	0.726	0.440
Sedentary time per week ≥ 21 hours	1.229 (0.290–5.203)	0.780	0.545 (0.249–1.193)	0.129	0.421
(D) STRATIFICATION BY SEX STATUS, UNADJUSTED
	Male, n = 51		Female, n = 88
	PR (95% CI)	P-VALUE	PR (95% CI)	P-VALUE	*P_i*
Total step counts per day ≥ 5.9 thousand	1.129 (0.379–3.366)	0.828	0.767 (0.321–1.831)	0.550	0.843
Light activity time per week ≥ 15.7 hours	0.886 (0.297–2.641)	0.828	0.900 (0.379–2.137)	0.810	0.977
Moderate-to-vigorous activity time per week ≥ 0.4 hours	0.800 (0.273–2.348)	0.685	0.548 (0.211–1.424)	0.217	0.769
Sedentary time per week ≥ 21 hours	1.556 (0.519–4.666)	0.431	1.067 (0.454–2.508)	0.882	0.866
(E) STRATIFICATION BY SEX STATUS, ADJUSTED
	Male, n = 51		Female, n = 88
	PR (95% CI)	P-VALUE	PR (95% CI)	P-VALUE	*P_i*
Total step counts per day ≥ 5.9 thousand	2.217 (0.861–5.710)	0.099	1.455 (0.566–3.740)	0.437	0.567
Light activity time per week ≥ 15.7 hours	1.535 (0.401–5.884)	0.532	1.400 (0.588–3.336)	0.448	0.805
Moderate-to-vigorous activity time per week ≥ 0.4 hours	1.462 (0.608–3.515)	0.396	0.704 (0.304–1.629)	0.412	0.349
Sedentary time per week ≥ 21 hours	0.830 (0.258–2.676)	0.755	0.675 (0.297–1.534)	0.348	0.958

[i] Definitions: CAD, coronary artery disease; PR, prevalence ratio; CI, confidence interval; P_i, P-value for interaction. Adjusted for age and sex.

Table 5

Unadjusted and adjusted associations of objective physical activity metrics with more severe CTA-detected CAD, n = 28.

	UNADJUSTED		ADJUSTED
	PR (95% CI)	P-VALUE	PR	P-VALUE
Total step counts per day ≥ 5.9 thousand	0.429 (0.138–1.329)	0.142	0.480 (0.128–1.797)	0.276
Light activity time per week ≥ 15.7 hours	0.429 (0.138–1.329)	0.142	0.464 (0.138–1.559)	0.214
Moderate-to-vigorous activity time per week ≥ 0.4 hours	0.571 (0.185–1.763)	0.330	0.624 (0.199–1.955)	0.418
Sedentary time per week ≥ 21 hours	2.022 (0.653–6.262)	0.222	1.676 (0.464–6.051)	0.430

[i] Definitions: CAD, coronary artery disease; PR, prevalence ratio; CI, confidence interval. Adjusted for age and sex.

Articles in this issue

DOI: https://doi.org/10.5334/gh.1398 | Journal eISSN: 2211-8179

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Language: English

Submitted on: Sep 3, 2024

Accepted on: Jan 23, 2025

Published on: Feb 10, 2025

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

HIV,

accelerometry,

physical activity,

cardiovascular disease,

computed coronary angiography

© 2025 Chinonso C. Opara, Christine Horvat Davey, Cissy Kityo, Ellen Brinza, Rashidah Nazzinda, Marcio Summer Bittencourt, Vitor Oliveira, Allison R. Webel, Chris T. Longenecker, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 20 (2025): Issue 1

Objectively Measured Physical Activity among People with and without HIV in Uganda: Associations with Cardiovascular Risk and Coronary Artery Disease

Figures & Tables

Figure 1

Table 1

Table 2

Table 3

Table 4

Table 5

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