Physical function limitation among gay and bisexual men aged ≥55 years with and without HIV: findings from the Australian Positive and Peers Longevity Evaluation Study (APPLES)
David C. Boettiger
A B C * , Md. Hamidul Huque D , Mark Bloch A E , Ian Woolley F G , David J. Templeton A H I , Matthew G. Law A , Neil Fraser J , Jennifer Hoy F and Kathy Petoumenos A
+ Author Affiliations
- Author Affiliations
A Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
B Institute for Health and Aging, University of California, San Francisco, CA, USA.
C Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
D Neuroscience Research Australia, Sydney, NSW, Australia.
E Holdsworth House Medical Practice, Sydney, NSW, Australia.
F Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Vic., Australia.
G Monash Infectious Diseases, Monash Health and Centre for Inflammatory Diseases, Monash University, Melbourne, Vic., Australia.
H Department of Sexual Health Medicine, Sydney Local Health District, Sydney, NSW, Australia.
I Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
J Positive Life NSW, Sydney, NSW, Australia.
Sexual Health 19(6) 533-545 https://doi.org/10.1071/SH22085
Submitted: 20 May 2022 Accepted: 16 August 2022 Published: 12 September 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: As people living with HIV now have a life expectancy approaching that of the general population, clinical care focuses increasingly on the management and prevention of comorbidities and conditions associated with aging. We aimed to assess the prevalence of physical function (PF) limitation among gay and bisexual men (GBM) and determine whether HIV is associated with severe PF limitation in this population.
Methods: We analysed cross-sectional data from GBM aged ≥55 years in the Australian Positive and Peers Longevity Evaluation Study who completed a self-administered survey on health and lifestyle factors. PF was measured using the Medical Outcomes Study–Physical Functioning scale. Factors associated with severe PF limitation were assessed using logistic regression.
Results: The survey was completed by 381 men: 186 without HIV and 195 with HIV. Median age was 64.3 years for GBM without HIV and 62.1 years for GBM with HIV. Compared with men without HIV, those with HIV had higher proportions of severe (13.3% vs 8.1%) and moderate-to-severe (26.7% vs 24.2%) PF limitation. Severe PF limitation commonly involved difficulty with vigorous activity (95% with severe PF limitation described being limited a lot), climbing several flights of stairs (68.4% limited a lot), bending, kneeling or stooping (60.5% limited a lot), and walking 1 km (55.0% limited a lot). In a model adjusted for age, body mass index, typical duration of physical activity, psychological distress, and number of comorbidities, we found a significant association between HIV and severe PF limitation (adjusted odds ratio 3.3 vs not having HIV, 95% confidence interval 1.3–8.7).
Conclusions: The biological mechanisms underlying this association require further investigation, particularly given the growing age of the HIV population and inevitable increase in the burden of PF limitation.
Keywords: aging, Australia, gay and bisexual, HIV, men, physical, physical function, physical function limitation.
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