Aging with HIV: The Interplay of Neighborhood Level Social Vulnerability, Social Support, and Physical Activity

Abstract

Introduction: As the population of people living with HIV (PLHIV) ages, maintaining physical activity (PA) levels—particularly moderate-to-vigorous physical activity (MVPA)—is critical to preserving health and quality of life. However, social determinants of health, such as neighborhood disadvantage and limited social support, may pose barriers to engaging in PA. This study examined the associations between social vulnerability, social support, and MVPA in PLHIV aged 50 and older.Methods: We conducted a cross-sectional analysis of 198 PLHIV aged ≥50 from the PROSPER-HIV study. PROSPER-HIV participants were recruited from HIV clinics at four sites: University of Washington (Seattle, WA), University of Alabama at Birmingham (Birmingham, AL), Case Western Reserve University (Cleveland, OH), and The Fenway Institute (Boston, MA). MVPA was measured objectively via ActiGraph accelerometers. Social vulnerability was assessed using the Social Vulnerability Index (SVI), a geospatial measure derived from census data. Social support was measured using the Multifactorial Assessment of Perceived Social Support–Short Form (MAPSS-SF). Linear regression models estimated associations between SVI and minutes of MVPA per week, as well as between social support and minutes of MVPA per week, controlling for age, sex at birth, and site in both models. The analysis also examined whether social support moderated the relationship between SVI and MVPA. Results: Participants had a median of 110 minutes/week of MVPA (IQR: 48.03, 237.05). Higher SVI scores were marginally associated with lower MVPA in unadjusted models (β = -1.77; CI: -3.56, 0.02; p = 0.053), but this association was attenuated and not statistically significant after adjustment (β = -1.14; CI: -2.88, 0.61; p = 0.20). Social support was not significantly associated with MVPA in either unadjusted or adjusted or models (adjusted β = 0.22; CI: -1.41, 1.85; p = 0.79). There was no evidence of interaction between SVI and social support (p = 0.53). Age was inversely associated with MVPA, and MVPA varied significantly by study site. Conclusion: These findings suggest that socially vulnerable individuals may be less likely to be physically active, although the small sample size warrants caution in interpretation. Future research with larger samples is needed to better understand these relationships and the potential role of structural or contextual factors.