title: Physical activity and health outcomes among HIV-infected men who have sex with men: a longitudinal mediational analysis.
abstract: BACKGROUND
  Low physical activity is associated with depression, which may, in turn, negatively impact antiretroviral therapy (ART) adherence among HIV-infected individuals; however, prior studies have not investigated the relationships between physical inactivity and ART non-adherence.
  
  
  OBJECTIVE
  The purpose of this study was to examine the association of physical inactivity, depression, ART non-adherence, and viral load in HIV-infected men who have sex with men.
  
  
  METHODS
  The sample (N = 860) was from a large, multicenter cohort of HIV-infected patients engaged in clinical care.
  
  
  RESULTS
  Across time, depression mediated the relationship between physical inactivity and ART non-adherence (γ = 0.075) and the relationship between physical inactivity and viral load (γ = 0.05). ART non-adherence mediated the relationship between depression and viral load (γ = 0.002) and the relationship between physical inactivity and viral load (γ = 0.009).
  
  
  CONCLUSIONS
  Low levels of physical activity predicted increased depression and poor ART adherence over time, which subsequently predicted higher viral load.
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA, ablashill@partners.org.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Blashill
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Heidi
authors.initials: H
authors.lastname: Crane
authors.forename: Jessica F
authors.initials: JF
authors.lastname: Magidson
authors.forename: Chris
authors.initials: C
authors.lastname: Grasso
authors.forename: W Christopher
authors.initials: WC
authors.lastname: Mathews
authors.forename: Michael S
authors.initials: MS
authors.lastname: Saag
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
mesh_terms: D000328:Adult; D003863:Depression / Q000150:complications* / Q000523:psychology*; D015658:HIV Infections / Q000150:complications* / Q000523:psychology* / Q000821:virology; D006304:Health Status; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D009043:Motor Activity; D011446:Prospective Studies; D019562:Viral Load