The relationship between substance use and physical activity among people living with HIV, chronic pain, and symptoms of depression: a cross-sectional analysis

AIDS Care. 2023 Feb;35(2):170-181. doi: 10.1080/09540121.2022.2136349. Epub 2022 Oct 19.


ABSTRACTChronic pain, depression, and substance use are common among people living with HIV (PLWH). Physical activity can improve pain and mental health. Some substances such as cannabis may alleviate pain, which may allow PLWH to participate in more physical activity. However, risks of substance use include poorer mental health and HIV clinical outcomes. This cross-sectional analysis examined the relationships of self-reported substance use (alcohol, cannabis, and nicotine use), gender, and age with self-reports of walking, moderate physical activity, and vigorous physical activity, converted to Metabolic Equivalent of Task Units (METs), among 187 adults living with HIV, chronic pain, and depressive symptoms in the United States. Women reported less walking, vigorous activity, and total physical activity compared to men. Individuals who used cannabis reported more vigorous physical activity relative to those who did not use cannabis. These findings were partially accounted for by substance use*gender interactions: men using cannabis reported more vigorous activity than all other groups, and women with alcohol use reported less walking than men with and without alcohol use. Research is needed to increase physical activity among women who use substances and to evaluate reasons for the relationship between substance use and physical activity among men.

Keywords: Substance use; chronic pain; depression; physical activity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chronic Pain* / epidemiology
  • Chronic Pain* / psychology
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / psychology
  • Exercise
  • Female
  • HIV Infections* / epidemiology
  • HIV Infections* / psychology
  • Humans
  • Male
  • Substance-Related Disorders* / epidemiology
  • Substance-Related Disorders* / psychology
  • United States / epidemiology