Tailored text messages plus motivational interviewing sustain MVPA in older adults with HIV

A randomized controlled trial investigated whether tailored text messages could help sustain moderate-to-vigorous physical activity (MVPA) in people with HIV (PWH) aged 50 and older. The study initially randomized 118 participants, with 92 re-randomized at 16 weeks to receive either tailored text messages (based on Two Minds Theory and daily barrier surveys) added to motivational interviewing (MI) or educational control messages added to MI. The primary outcome was sustained MVPA minutes per day, measured by ActiGraph monitor and self-report over 12 weeks of messaging (total study duration 28 weeks).

At the 28-week assessment, 22 of 29 participants in the tailored-message group and 25 of 32 in the educational-control group provided data. The tailored-message group maintained MVPA with a mean of 48.8 minutes/day (SD=45.8), while the educational-control group decreased to a mean of 40.7 minutes/day (SD=24.6). The group-by-time interaction was statistically significant (p=.01). Exploratory analyses suggested the tailored messaging effect was additive to the foundational MI. Secondary outcomes of exercise self-efficacy and perceived health were also reportedly higher in the tailored-messaging group over time, though specific numerical results were not provided.

Safety and tolerability data were not reported. The study's findings were robust to attrition in intent-to-treat analysis and were consistent across both actigraphy and self-reported MVPA measures. However, key limitations include the small sample sizes at the final 28-week time point (n=22 and n=25), the lack of reported data on long-term sustainability beyond 28 weeks, and the absence of safety or tolerability information. Funding sources and conflicts of interest were also not reported.

For clinical practice, this RCT provides preliminary evidence that a tailored text-message intervention may help sustain physical activity as an adjunct to motivational interviewing in older adults with HIV. The intervention's effect appears additive. However, clinicians should interpret these findings cautiously due to the small final cohort, unknown durability of effect, and lack of safety data. The approach represents a low-burden, scalable potential component of a broader physical activity support strategy.