The effects of behavioral change interventions and behavior change techniques in promoting physical activity in people with HIV: a systematic review and meta-analysis

Most people living with HIV remain physically inactive, despite strong evidence that physical activity improves health outcomes and reduces premature mortality. While behavioral interventions are known to promote physical activity, few systematic reviews have focused specifically on these strategies for people with HIV. This review addresses that gap by evaluating the overall impact of behavioral interventions and examining the effectiveness of individual behavior change techniques used within them. A comprehensive search of four databases, completed by October 31, 2024, identified ten eligible studies, most of which had a low risk of bias. When data allowed, a meta-analysis was conducted and showed that behavioral interventions significantly increased both step counts and self-reported physical activity. Behavior change techniques were identified using the Behavior Change Technique Taxonomy version one, and a percentage effectiveness ratio was calculated for each technique. Of the ninety-three techniques in the taxonomy, only twenty were used across studies. Techniques that were used less frequently, such as providing social support, showed higher effectiveness. These findings suggest that future interventions should incorporate a wider range of evidence-based techniques and be tailored to the specific needs of people living with HIV to maximize the benefits of physical activity.