Promoting Physical Activity in the Context of Clinical Care for People With HIV and Unhealthy Substance Use in the United States: A Qualitative Study

ABSTRACT: Using qualitative methods, we investigated barriers and facilitators to promoting physical activity in an HIV clinic in New Haven, CT. We conducted focus groups with HIV clinicians/staff (n = 12) and interviews among people with HIV with unhealthy substance use (n = 10). Data collection and deductive analysis were guided by the Health Equity Implementation Framework domains. Innovation barriers included lack of evidence-based interventions; facilitators included behavioral strategies and app-based programs. Clinical encounter barriers included lack of protocols and competing priorities; facilitators included discussing the benefits of physical activity. Recipient-level barriers included cost, physical capacity restrictions, and unhealthy substance use; facilitators included social support and tailoring interventions to individual interests/fitness levels. Contextual barriers included budget restrictions and lack of billing options; facilitators included having a physical activity specialist and infrastructure to link patients to physical activity services. Future research should investigate the feasibility of implementing a physical activity intervention into HIV clinical care.