Geographical Differences in Self-Reported Functional Impairment of People Living with HIV

One of the keys to healthy aging is the maintenance of a high level of physical function. Functional impairments may occur earlier among people living with HIV compared to those without HIV. In a smaller group of U.S.-based REPRIEVE participants, researchers previously found physical function impairment among nearly 50% of participants (measured by time to rise from a chair and four-meter walking speed). The current analysis explored differences across regions in self-reported physical function, and the factors that are associated with physical function in the larger, global REPRIEVE cohort.

Among 7,736 REPRIEVE participants, the average age was 50 years old, 30% were female, and 43% were Black. The study found that 64% had no functional impairments, 28% had some impairment, 8% had moderate impairment, and <0.5% had severe impairment. The investigators found that increased functional impairment was associated with the following:

  • Living in the South Asia region (and lower impairment in Southeast/East Asia)
  • Older age
  • Being female
  • Being Asian or Black
  • Having more obesity
  • Having been on ART for a longer period of time, longer thymidine analogue exposure, and lower CD4 T-cells
  • Certain ART regimens

The investigators also found that some or moderate/severe functional impairments were associated with small increases (0.3- 0.5 points) in heart disease risk score. Moderate/severe functional impairments were also associated with greater likelihood of metabolic syndrome (a cluster of conditions that occur together and raises one’s risk of heart disease) or a high waist circumference.

Key Takeaways: We’ve long known that exercise is important to prevent heart disease. In this study, researchers show that the level of activity and ability to do simple tasks like getting up from a chair or walking faster are related to heart disease risk. This extends our understanding to a global population. In the future, this study will be able to relate an individual’s ability to do simple tasks to the development of heart problems and worsening of blockages in the blood vessels that feed the heart.

Erlandson, K.M.; Fitch, K.V.; McCalllum, S.A.; Ribaudo, H.J.; Overton, E.T.; Zannie, M.V.; Bloomfield, G.S.; Brown. T.T.; Fichtenbaum, C.J.; Bares, S.; Aberg, J.A.; Douglas, P.S.; Fulda, E.S.; Santana-Bagur, J.L.; Castro, J.G.; Moran, L.E.; Mave, V.; Supparatpinyo, K.; Ponatshego, P.L.; Schechter, M.; Grinspoon, S.K. Geographical Differences in the Self-Reported Functional Impairment of People With Human Immunodeficiency Virus (HIV) and Associations With Cardiometabolic Risk. Clinical Infectious Diseases, 15 February 2022,