The Impact of Social Vulnerability on Exercise Outcomes: A Longitudinal Study of Physical Function in Older People With HIV

Abstract

Objectives: To examine whether the Social Vulnerability Index (SVI) moderated changes in physical function during supervised and unsupervised phases of an exercise intervention in older adults with HIV. Methods: This exploratory analysis used data from the High Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults with HIV. Participants completed 16 weeks of supervised high- or moderate-intensity exercise, followed by 12 weeks of unsupervised support (personalized coaching or educational text messages). Linear mixed-effects models assessed SVI moderation effects on 400-meter walk time (400-MWT) and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF). Results: Among 117 participants, SVI did not moderate 400-MWT in either phase or PROMIS-PF during supervised exercise; however, higher SVI was associated with declines in self-reported physical function during the unsupervised phase (P = .03), robust to adjustment and sensitivity analyses. Conclusions: Findings suggest supervised exercise benefits participants across vulnerability levels, but sustained support may be needed to prevent disparities. Parent Trial Information: The High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults with HIV trial, ClinicalTrials.gov: NCT04550676.