On İki Haftalık Aerobik Egzersiz, Uganda'da Sanatta HIV Pozitif Müşterilerde Anksiyete ve Depresyonu İyileştiriyor

Öz

Amaç: Çalışma, 12 haftalık bir aerobik egzersiz programının HIV pozitif bireylerde anksiyete ve depresyon üzerindeki etkisini değerlendirerek bu alandaki bilgi boşluğunu doldurmayı amaçlamıştır. Yöntem: Uganda'daki Genel Askeri Hastanesi'nde gerçekleştirilen çalışmada yarı deneysel bir tasarım kullanılmıştır. Kantitatif veriler, anketler aracılığıyla ve çalışmaya katılan, antiretroviral tedavi gören 135 HIV pozitif bireyden oluşan bir örneklemden toplanmıştır. Veriler, t-testleri kullanılarak analiz edilmiş ve katılımcılar arasında depresyon ve anksiyete semptomlarında önemli azalmalar olduğu belirlenmiştir. Bulgular: Bulgular, aerobik egzersiz programına katılan bireylerde depresyon belirtilerinde %58,5, anksiyete belirtilerinde ise %72 oranında azalma olduğunu ortaya koymuştur. Her iki grupta da iyileşmeler gözlemlenmiş, ancak deney grubunda daha belirgin azalmalar tespit edilmiştir. Ayrıca, HIV ile yaşayan bireylerde depresyon ve anksiyetenin, HIV taşımayan bireylere kıyasla iki ila dört kat daha yaygın olduğu ve depresyonun, yüksek aktif antiretroviral tedavi (HAART) kullananlarda daha sık görüldüğü belirtilmiştir. Sonuç: Elde edilen sonuçlar, antiretroviral tedavi gören HIV pozitif bireyler için aerobik egzersizin değerli bir yardımcı tedavi olabileceğini desteklemektedir. İyi yapılandırılmış ve denetimli aerobik egzersizin, HIV ile yaşayan bireylerin klinik sonuçlarını iyileştirmek için önemli olduğu vurgulanmıştır.

Anahtar Kelimeler

• Aerobik egzersiz
• Depresyon
• Endişe
• HIV pozitif müşteriler
• Antiretroviral tedavi

Twelve Weeks Aerobic Exercise Improves Anxiety and Depression in HIV Positive Clients on Art in Uganda

Öz

Aim: The study aimed at bridging the gap by assessing the impact of a 12-week aerobic exercise program on anxiety and depression for HIV-positive clients. Methods: The study, conducted at the General Military Hospital in Uganda, employed a quasi-experimental design. Quantitative data was collected using questionnaires and a sample of 135 people living with HIV on antiretroviral therapy engaged in the study. Quantitative data was analyzed using t-tests, revealing significant reductions in depression and anxiety symptoms among participants. Results: The findings demonstrated a 58.5% reduction in depression symptoms and a 72% decrease in anxiety symptoms among participants engaged in aerobic exercises. Both groups exhibited improvements, with the experimental group showing greater reductions. The results further revealed that depression and anxiety are two to four times more common in individuals living with HIV than in those without the virus, and depression is also more common in those on HAART than in those without the virus. Conclusion: The results support the potential of aerobic exercise as a valuable adjunct therapy for people living with HIV on antiretroviral therapy. Well-structured and supervised aerobic exercise was found to be essential for improving the clinical outcomes of PLHIV on ART.

Anahtar Kelimeler

• Aerobics exercise
• Depression
• Anxiety
• HIV positive clients
• Antiretroviral therapy

Kaynakça

1. Antoni, M. H., Cruess, D. G., Klimas, N., Maher, K., Cruess, S., Kumar, M., & et al. (2002). Stress management and immune system reconstitution in symptomatic HIV-infected gay men over time: Effects on transitional naïve T cells (CD4+ CD45RA+ CD29+). American Journal of Psychiatry, 159(1), 143-145.
2. Askari, J., Saberi-Kakhki, A., Taheri, H., Yassini, S. M., & Hassanbeigi, A. (2020). The effect of aerobic exercise on various symptoms of depression: the mediating role of quality of life. Sport Sciences for Health, 16, 273-280.
3. Berhan, A., Bayleyegn, B., & Getaneh, Z. (2022). HIV/AIDS Associated Lymphoma: Review. Blood and lymphatic cancer: targets and therapy, 12, 31–45. https://doi.org/10.2147/BLCTT.S361320
4. Bopp, C., Phillips, K. D., Fulk, L. J., & Hand, G. A. (2003). Clinical implications of therapeutic exercise in HIV/AIDS. Journal of the Association of Nurses in AIDS Care, 73.
5. Broman-Fulks, J. J., Berman, M. E., Rabian, B. A., & Webster, M. J. (2004). Effects of aerobic exercise on anxiety sensitivity. Behaviour research and therapy, 42(2), 125-136.
6. Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., ... & Tate, D. F. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079.
7. Daniels, A. K., & Van Niekerk, R. L. (2018). The impact of a therapeutic exercise intervention on depression and body self-image in HIV-positive women in sub-Saharan Africa. HIV/AIDS (Auckland, N.Z.), 10, 133–144. https://doi.org/10.2147/HIV.S167005
8. Demers, N. R. (2013). The relationship between exercise and mental health in college students. DHIS2 (2019) District Health Information System.

9. Eggleton, J. S., & Nagalli, S. (2020). Highly active antiretroviral therapy (HAART). In StatPearls. StatPearls Publishing.
10. Fekadu, N., Shibeshi, W., & Engidawork, E. (2017). Major depressive disorder: pathophysiology and clinical management. J Depress Anxiety, 6(1), 255-257.
11. Grace, J. M., Semple, S. J., & Combrink, S. (2015). Exercise therapy for human immunodeficiency virus/AIDS patients: Guidelines for clinical exercise therapists. Journal of exercise science and fitness, 13(1), 49–56. https://doi.org/10.1016/j.jesf.2014.10.003
12. Guerra, L., Mesquita, T., Soares, J., Morgan, D., & Knackfuss, M. (2015). Resisted exercise, morphological and functional standards, and quality of life of people living with HIV/AIDS. J Sports Med Phys Fitness,, 56, 470-475.
13. Hand, G. A., Lyerly, G. W., Jaggers, J. R., & Dudgeon, W. D. (2009). Impact of Aerobic and Resistance Exercise on the Health of HIV-Infected Persons. American journal of lifestyle medicine, 3(6), 489–499. https://doi.org/10.1177/1559827609342198
14. Heidary, A., Emami, A., Eskandaripour, S., Saiah, A., Hamidi, S., & Shahbazi, M. (2011). Effects of aerobic exercise on anxiety. Procedia-Social and Behavioral Sciences, 30, 2497-2498.
15. Heissel, A., Zech, P., Rapp, M. A., Schuch, F. B., Lawrence, J. B., Kangas, M., & Heinzel, S. (2019). Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis. Journal of psychosomatic research, 126, 109823.
16. Ibeneme, S., Irem, F., Iloanusi, N., Ezuma, A., Ezenwankwo, F., Okere, P., & Fortwengel, G. (2019). Impact of physical exercises on immune function, bone mineral density, and quality of life in people living with HIV/AIDS: a systematic review with meta-analysis. BMC infectious diseases, 19, 1-18.
17. Jaggers, J., & Hand, G. (2016). Health benefits of exercise for people living with HIV: A review of the literature. American journal of lifestyle medicine,, 10(3), 184-192.
18. Jayakody, K., Gunadasa, S., & Hosker, C. (2014). Exercise for anxiety disorders: systematic review. British journal of sports medicine, 48(3), 187-196.
19. Kabthymer, R. H., Nega Techane, S., Muche, T., Ali Ewune, H., Mekonnen Abate, S., & Feyisso Shaka, M. (2021). Overweight and obesity among adult HIV infected peoples receiving ART in Ethiopia: a systematic review and meta-analysis. Journal of Primary Care & Community Health, 12, 2150132721993647.
20. Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ‐9: validity of a brief depression severity measure. Journal of general internal medicine, 16(9), 606-613.
21. Kumah, E., Boakye, D. S., Boateng, R., & Agyei, E. (2023). Advancing the Global Fight Against HIV/Aids: Strategies, Barriers, and the Road to Eradication. Annals of global health, 89(1), 83. https://doi.org/10.5334/aogh.4277
22. Lacob, S. A., Lacob, D. G., & Jugulete, G. (2017). Improving the adherence to antiretroviral therapy, a difficult but essential task for succesful HIV treatment-clinical points of view and practical consideration. Front Pharmacol, 8, 831.
23. National Library of Medicine (US). Friends. (2006). MedlinePlus (Vol. 5, No. 1). National Institutes of Health and the Friends of the National Library of Medicine.
24. Nkweke, M. (2021). Effects of a 12-week aerobic exercise programme on human immunodeficiency virus-associated neurocognitive disorder in Nigeria. Pretoria: Doctoral dissertation, University of Pretoria.
25. Nokes, K. M., & Kendrew, J. (2001). Correlates of sleep quality in persons with HIV disease. Journal of the Association of Nurses in AIDS Care, 12(1), 17-22.
26. Nosrat, S., Whitworth, J. W., & Ciccolo, J. T. (2017). Exercise and mental health of people living with HIV: A systematic review. Chronic illness, 13(4), 299-319.
27. O’Brien, K. K., Tynan, A. M., Nixon, S. A., & Glazier, R. H. (2016). Effectiveness of aerobic exercise for adults living with HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC infectious diseases, 16(1), 1-56.
28. Pedersen, B. K., & Saltin, B. (2015). Exercise as medicine–evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian journal of medicine & science in sports, 25, 1-72.
29. Pollock, A., Campbell, P., Cheyne, J., Cowie, J., Davis, B., McCallum, J., & et al. (2020). Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. The Cochrane database of systematic reviews, 11(11), CD013779. https://doi.org/10.1002/14651858.CD013779
30. Poon, K. (2022). Effects of Aerobic Exercise and High-Intensity Interval Training on the Mental Health of Adolescents Living in Poverty: Protocol for a Randomized Controlled Trial. JMIR research protocols, 11(1), e34915.
31. Prabhu, S., & Van wagoner, N. (2023). Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome (HIV/AIDS):. An Overview. Sexually Transmissible Oral Diseases, 51-71.
32. Salmon, P. (2001). Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clinical psychology review, 21(1), 33-61.
33. Seid, S., Abdu, O., Mitiku, M., & Tamirat, K. S. (2020). Prevalence of depression and associated factors among HIV/AIDS patients attending antiretroviral therapy clinic at Dessie referral hospital, South Wollo, Ethiopia. International Journal of Mental Health Systems, 14, 1-8.
34. Smith, P. J., & Merwin, R. M. (2021). The role of exercise in management of mental health disorders: an integrative review. Annual review of medicine, 72, 45-62.
35. Ssebiryo, F. E. (2011). Disparities in HIV/AIDS Progression among Children: A Case of Uganda (Doctoral dissertation).
36. Sujianto, U. (2021). Turnitin: Effects of Aerobic Exercise on Depression and CD4 Counts in People Living with HIV.
37. Tran, B. X., Ho, R. C. M., Ho, C. S. H., Latkin, C. A., Phan, H. T., Ha, G. H., & et al. (2019). Depression among Patients with HIV/AIDS: Research Development and Effective Interventions (GAPRESEARCH). International journal of environmental research and public health, 16(10), 1772. https://doi.org/10.3390/ijerph16101772
38. West, N. S. (2021). Mental Health Among People Living with HIV And Impacts on the HIV Care Continuum: A Focus on Rakai, Uganda (Doctoral Dissertation, Johns Hopkins University).
39. Younai, F. S. (2013). Thirty years of the human immunodeficiency virus epidemic and beyond. International journal of oral science, 5(4), 191-199.
40. Zarshenas, S., Houshvar, P., & Tahmasebi, A. (2013). The effect of short-term aerobic exercise on depression and body image in Iranian women. Depression research and treatment.
41. Zimek, D., Miklusova, M., & Mares, J. (2023). Overview of the Current Pathophysiology of Fatigue in Multiple Sclerosis, Its Diagnosis and Treatment Options–Review Article. Neuropsychiatric Disease and Treatment, 2485-2497.