Predictors of Body Fat Redistribution in Persons Living with HIV/AIDS

Kirksey, Kenn M.

Saturday, 29 October 2011: 3:55 PM

Kenn M. Kirksey, RN, PhD, ACNS-BC
Center for Nursing Research, Seton Healthcare Family, Austin, TX
Elizabeth F. Sefcik, RN, PhD, GNP
College of Nursing and Health Sciences, Texas A&M University-Corpus Christi, Corpus Christi, TX
Mary Jane Hamilton, RN, PhD
College of Nursing & Health Sciences, Texas A&M University-Corpus Christi, Corpus Christi, TX
Adama Brown, PhD
School of Nursing, University of Texas at Austin, Austin, TX

Learning Objective 1: The learner will be able to identify lipodystrophy-associated factors in persons living with HIV/AIDS.

Learning Objective 2: The learner will be able to delineate effective strategies in caring for individuals experiencing physical and psychological changes associated with HIV-related body fat redistribution.

Purpose: HIV disease and antiretroviral treatments can be accompanied by intense physical and psychological symptoms, including body fat redistribution. Lipodystrophy is often associated with increased illness perception and stigmatization. Amelioration of the anthropomorphic and metabolic changes, through provider-directed or self-care measures, can be challenging and often results in reduced medication adherence and impacts quality of life. The purpose of this study was to identify correlates of HIV-related lipodystrophic symptoms based upon a team-generated conceptual model exploring associations between personal characteristics, resources, illness perception and severity, and changes in symptoms, adherence and quality of life.

Methods: This study was a sub-analysis of 188 individuals who reported lipodystrophy in a randomized controlled trial (N=190) that tested a self-care symptom management manual. Data on body fat changes were collected at two time points (baseline and 2 months) at 3 sites in the southern United States. Descriptive and multivariate statistics were calculated on demographic variables, objective indicators and perceived body fat changes, illness perception, and stigma.

Conclusions: 64.2% were male, 45.8% Latino, 37.9% African American and 14.7% Caucasian with a mean age of 42.2 years (SD 9.0). Significant (p<.05) correlates of lipodystrophy included illness perception (r=-.40), stigma (r=-.33) and quality of life (r=.32). Self-reported objective indicators of lipodystrophy did not correlate significantly with perceived body fat changes. Significant predictors of lipodystrophy (adjusted R²=.185, F=15.1, p=.000) included stigma (Beta=-.19, p=.014) and illness perception (Beta=-.28, p=.001).

Implications: Interventions to reduce stigma and illness perception should be targeted to younger persons living with HIV to decrease negative perceptions of body fat changes. Clearly, these negative, cognitive indices have a greater effect than objective indicators of lipodystrophy upon the individual’s perceptions of their bodies. Clinician assessment should include both subjective and objective data related to lipodystrophic symptoms

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