Key result
High food costs, unsafe environments, and peer norms identified as modifiable cardiovascular prevention barriers in HIV.
Why the study?
Cardiometabolic disease has emerged as a critical determinant of long-term health in people living with HIV, but HIV care models often prioritize viral suppression over integrated cardiovascular prevention.
Observational (n=20)
Yes
Modifiable social and structural barriers, including food costs and unsafe environments, hinder cardiovascular prevention in people with HIV, highlighting the need for integrated structural supports within HIV care.
Answers are grounded in this paper and cite their sources.
Highlights patient-provider perspectives on integrated HIV-cardiovascular care; leaves open whether such models improve outcomes.
BACKGROUND: As progress toward the UNAIDS 95-95-95 goals has transformed HIV into a chronic, manageable condition, cardiometabolic disease has emerged as a critical determinant of long-term health among people living with HIV. Despite effective antiretroviral therapy, people with HIV remain at elevated risk for hypertension, diabetes, and cardiovascular disease, while HIV care models often prioritize viral suppression over integrated cardiovascular prevention. OBJECTIVE: This study aimed to explore the social and structural determinants that shape cardiovascular preventive health behaviors among people with HIV in the Southern United States to inform the development of interventions that promote sustained health outcomes. METHODS: We conducted a qualitative descriptive study with twenty people with HIV aged ≥ 35 years, each living with at least one cardiometabolic condition, recruited from three HIV clinics in the Southern United States. Photo-elicitation integrated with semi-structured interviews allowed participants to document and interpret their experiences related to diet, physical activity, lifestyle behaviors, and health monitoring. RESULTS: Thematic analysis mapped findings to five determinant domains: economic stability, neighborhood and environment, social and community context, education, and healthcare access and quality. Participants (median age 57; predominantly African American/Black; most living with HIV for more than 10 years) identified three intersecting, modifiable barriers: the high cost of healthy food, unsafe or poorly designed environments limiting physical activity, and family or peer norms reinforcing unhealthy behaviors. CONCLUSIONS: These findings highlight the need to embed food insecurity screening, context-tailored activity counseling, family engagement strategies, and structural supports within HIV care to advance equitable cardiovascular prevention for people with HIV.
No takes yet. Share an insight, caveat, or question.
Kwawuvi et al. (2026) conducted an observational in HIV and cardiometabolic disease (n=20). Social and structural determinants was evaluated on Social and structural determinants shaping cardiovascular preventive health behaviors. A qualitative study of 20 people with HIV identified high food costs, unsafe environments, and unhealthy peer norms as key modifiable barriers to cardiovascular prevention.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: