The association between social drivers of health, HIV status and physical activity with perceived stress in U.S. women with or without HIV.

BACKGROUND

The physiological adaptation to chronic stress can have deleterious health effects. Although higher physical activity (PA) has been linked to lower stress, it is unknown whether social driver of health (SDOH) burden and HIV status impact the stress reduction effects of PA due to their unique contributions to stress.

METHODS

Using a cross-sectional sample (n = 444) from the Women's Interagency HIV Study during 2014-2019, multivariate linear regression modeling was used to estimate the effect of SDOH burden and PA on stress. SDOH burden was defined as the sum of individual-level indicators: inadequate housing, income, and education as well as unemployment, and food insecurity.

RESULTS

Unadjusted, there was a significant relationship between SDOH burden, Heavy PA and Moderate PA with stress (rs = 0.22 [p < .001], -0.10 [p < .05], and - 0.11 [p < .05] respectively) After adjusting for age, HIV status and race, and including both SDOH and PA, only SDOH predicted stress (β = 0.20, 95% CI [0.6, 1.87]; p < .001). Among this sample, food insecurity was the strongest predictor of stress, reducing the effects of PA when included in the model (β = 0.24, 95% CI [2.38, 5.99]; p < .001).

CONCLUSIONS

Findings indicated that, after adjusting for age, HIV status and race, SDOH burden reduced the association between PA and stress, and was a stronger predictor of stress in women living with HIV than those living without HIV. The impact of food insecurity appears to be a powerful driver of stress in both women living with and without HIV.