Optimization of a Behavioral Intervention to Increase Physical Activity in Older Adults Living With HIV

The goal of this clinical trial is to examine 3 interventions designed to increase physical activity in older adults with HIV. We will examine 3 potential components of an intervention package: physical activity coaching, cognitive behavioral therapy targeted toward common barriers to physical activity such as low motivation or chronic pain, and a Fitbit-based social support intervention. Our primary outcome will be physical activity, defined as steps per day. Results will guide choice of intervention components to be used in an optimized behavioral intervention.

Inclusion Criteria:HIV positive: defined by HIV antibody, detectable HIV RNA in plasma, or a note from the participant's HIV care provider.Must be on continuous antiretrotroviral therapy (ART) for > 3 months, as assessed via self-report. Any participant not on continuous ART should have this as the main focus of their treatment.Low PA: defined as self-report of < 90 minutes of moderate-vigorous PA (MVPA) per week in the previous 3 months. NOTE: This is easily ascertained during a screener and ensures enrollment of a population that needs to increase PA.Medically cleared for moderate PA. If participants report a) a history of cardiovascular disease including known coronary artery disease, peripheral vascular disease, heart failure, or stroke; b) diabetes; or c) chest pain, shortness of breath, or dizziness or syncope either at rest or during activity in the past 3 months, then they must have medical clearance by a physician or primary care provider.Age 50 years or older.Proficiency in English: sufficient to engage in informed consent, understand assessments and materials provided, and engage and use Fitbit application (all materials provided in English).Cognitive capacity: sufficient to provide consent, documented by acceptable answers in a consent "teach-back" process.Able to ambulate without assistive devicesAbility to use the FitBit application, as demonstrated to study staff.Exclusion Criteria:Exclusion CriteriaMedical conditions or physical or neurocognitive limitations that interfere with PA or study participation. Participants will be excluded if, in the opinion of an investigator or primary provider, participation in the study would be unsafe, not possible, or not in the participant's best interest.Hazardous substance use, assessed via a score ≥15 on the Alcohol Use Disorders Identification Test (AUDIT) or ≥6 on the Drug Abuse Screening Test (DAST).