Wellness with HIV

A presentation on the Healthy Life Plus (HL+) program conducted by the HIV

Men’s Health Promotion team at ACON

Andrew Buchanan

Team Leader, HIV Health Promotion, ACON

Overview

• Why HL+? What is HL+?

• Issue of Adherence

• Changes and Results

• Planning your Program

Why HL+?

• With HAART, people with HIV living longer

• Side effects + lifestyle issues

• Studies* shown favourable results combining exercise and diet

• HL+ Program developed in response

* Finch et.al 2006; Roubenoff et.al 2002

HL+ - What is it?

• Health and Wellness program targeted specifically at HIV positive people who meet certain criteria

• Focus on exercise and diet

• Runs over 12 weeks

HL+ - What is it?

• Comprises 3 streams:

• Individualised training programs with a Personal Fitness Trainer

• Weekly presentations on health topics in seminar format with peer-group discussion

• Pre- and post-program health screening and assessment

Fitness Training

• Appointment of a dedicated Personal Fitness Trainer

• Initial then fortnightly appointments

• Development of a personalised program

• 12 week’s complimentary membership at a centrally located gym

• Unlimited use of the gym and classes

Weekly Seminars

• Qualified specialist presenters as volunteers

• Peer support and group discussion

• Topics include:• Nutrition & Food Labeling/choice• Goal Setting & Body Image• Supplements and Vitamins• Core Stability• Cardio-vascular issues with HIV• Complementary Therapies eg Shiatsu• Yoga

Presenters and Topics

Supplements

Kira Sutherland B.Sc

Awareness Institute

Goal Setting

Rob Derbyshire ISC Dip

Health Trio

Core Stability

Craig Osborne B.Sc

Thrive Chiropractic

Cardiovascular System and HIV

Dr David Baker

East Sydney Doctors

Health Screening

• Undertaken by Albion Street Centre, Nutrition Development Division

• Baseline data gathered includes:– Anthropometry eg height, weight, waist, LBM etc– Fitness – BP and heart rate– Strength test– Biochemistry test results supplied

• Final data gathered at conclusion of program

• Comparison against original goals/objectives to determine effectiveness

Selection Criteria

• HIV positive

• Affected by social isolation

• Financially disadvantaged

• Experiencing some form of physical/psychological impairment due to HIV disease process or medication side effects, and co-morbidities

Issue: Adherence

• Spring 2004 program had a 42% completion rate

• Participant adherence averaged 53% over initial 3 years

Adherence - Changes

• Changes made in 2005 included:

• Introduction of personalised fitness program

• Instructor with specialist HIV and health knowledge

• Move to fortnightly seminars

• Provision of additional financial assistance/support through BGF

Adherence - Results

• Initial results indicated changes were effective in improving adherence

• 100% compliance in appointments, measures and evaluations

• 62% compliance in seminar attendance

• Gradual deterioration to an average of 63% adherence over past 2 years

Adherence 2005 - 2009

0

10

20

30

40

50

60

70

80

90

100

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Aug 2005 Aug 2006 Feb 2007 Aug 2007 Feb 2008 Feb 2009 Aug 2009

Adherence – New Changes

• Stronger and clearer up-front approach to client commitment and buy-in via:

1. Explicit statement of attendance requirements reinforced through clear wording in documentation

2. ‘Expectations Night’ held before the program commences outlining expectations and obligations

• Increased communication with participants

Results to date

• After 75% completion, we have a healthy 93% adherence rate across all activities

• 1 drop-out due to unforeseen circumstances

• Enthusiastic and committed participants

• Fun and participative sessions

Proposed Change

• Improve the ability to identify significant pre-existing health conditions via GP/Clinician clearance

• Example – TR has chronic Emphysema and requires breathing training and exercises before being able to do gym work

If you’re planning a program . . .

• Find reliable Gym and Trainer (preferably with understanding of HIV issues)

• Ensure internal capacity to sustain commitment to the program

• Rigorous compliance with selection criteria

• Communicate – often and enthusiastically

• Plan Execute Evaluate

Thank you