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The post-antiretroviral therapy era has transformed HIV into a chronic disease and non-HIV comorbidities (i.e., cardiovascular and mental diseases) are more prevalent in PLWH. The source of these non-HIV comorbidities aside from traditional risk factor include HIV infection, inflammation, distorted immune activation, burden of chronic diseases, and unhealthy lifestyle like sedentarism. Exercise is known for its beneficial effects in mental and physical health; reasons why exercise is recommended to prevent and treat difference cardiovascular and mental diseases in the general population. This cumulative thesis aimed to comprehend the relation exercise has to non-HIV comorbidities in German PLWH. Four studies were conducted to 1) understand exercise effects in cardiorespiratory fitness and muscle strength on PLWH through a systematic review and meta-analyses and 2) determine the likelihood of German PLWH developing non-HIV comorbidities, in a cross-sectional study. Meta-analytic examination indicates PLWH cardiorespiratory fitness (VO2max SMD = 0.61 ml·kg·min-1, 95% CI: 0.35-0.88, z = 4.47, p < 0.001, I2 = 50%) and strength (of remark lowerbody strength by 16.8 kg, 95% CI: 13–20.6, p< 0.001) improves after an exercise intervention in comparison to a control group. Cross-sectional data suggest exercise has a positive effect on German PLWH mental health (less anxiety and depressive symptoms) and protects against the development of anxiety (PR: 0.57, 95%IC: 0.36 – 0.91, p = 0.01) and depression (PR: 0.62, 95%IC: 0.41 – 0.94, p = 0.01). Likewise, exercise duration is related to a lower likelihood of reporting heart arrhythmias (PR: 0.20, 95%IC: 0.10 – 0.60, p < 0.01) and exercise frequency to a lower likelihood of reporting diabetes mellitus (PR: 0.40, 95%IC: 0.10 – 1, p < 0.01) in German PLWH. A preliminary recommendation for German PLWH who want to engage in exercise can be to exercise ≥ 1 time per week, at an intensity of 5 METs per session or > 103 MET·min·day-1, with a duration ≥ 150 minutes per week. Nevertheless, further research is needed to comprehend exercise dose response and protective effect for cardiovascular diseases, anxiety, and depression in German PLWH.
The purpose of this study was to examine the longitudinal relationship between problematic online gaming and subjective health complaints and depressive symptoms, and the moderation of console-gaming aggression (i.e. verbal aggression, camping, trolling) in this relationship. Participants were 202 adolescents (86% boys; M age = 12.99 years) in the 7(th) or 8(th) grade who played first-person shooter games. They completed questionnaires on problematic online gaming, console-gaming aggression, subjective health complaints, and depressive symptoms. Six months later (Time 2), they completed questionnaires on subjective health complaints and depressive symptoms again. Findings revealed that problematic online gaming and console-gaming aggression were positive predictors of Time 2 subjective health complaints and depressive symptoms, while controlling for Time 1 levels and gender. Moderating effects were found as well, indicating that high levels of console-gaming aggression increased the positive relationship between problematic online gaming and depressive symptoms. These effects were also replicated for verbal aggression, problematic online gaming, and subjective health complaints. These findings suggest the importance of considering the implications of console-gaming aggression and problematic online gaming for the physical and mental health of adolescents.
IMPACT SUMMARY
Prior State of Knowledge. Problematic online gaming and aggressive behaviors are linked to negative outcomes, including depression and subjective health complaints. Longitudinal research further supports this connection for depression, but not for subjective health complaints or various types of aggression via console games.
Novel Contributions. Few studies have focused on various types of aggression and the longitudinal associations among problematic online gaming, depression, and subjective health complaints, while controlling for previous levels of depression and subjective health complaints. The present research addresses these gaps.
Practical Implications. Findings of the present research has implications for clinicians and researchers concerned with identifying adolescents who might be at risk for negative outcomes.