Experiences and perceptions of weight change among people living with HIV receiving antiretroviral therapy: a qualitative systematic review and meta-synthesis
- 1School of Nursing (Nursing School of Smart Healthcare Industry), Henan University of Chinese Medicine
- 2Department of Infection Control, The First Affiliated Hospital of Henan University of Chinese Medicine
Abstract
Background: With improved survival following the widespread use of antiretroviral therapy (ART), weight change has become an important concern in the long-term care of people living with HIV. Weight loss and gain may carry medical, psychological, and sociocultural meanings and may influence body image, treatment perceptions, ART adherence, and weight-management behaviors. This review synthesized qualitative evidence on experiences and perceptions of weight change among people living with HIV receiving ART.
Methods: A systematic search of PubMed, Embase, Web of Science, Scopus, CINAHL, ProQuest, PsycINFO, China National Knowledge Infrastructure, Wanfang Data, VIP Database, and the Chinese Biomedical Literature Service System was conducted from database inception to June 2026 to identify qualitative studies examining experiences of weight change among people living with HIV receiving antiretroviral therapy. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Findings were synthesized using JBI meta-aggregation, and confidence was evaluated using CERQual.
Results: Seven studies were ultimately included, from which 57 findings were extracted, grouped into 12 categories, and synthesized into three overarching findings: the multiple meanings of weight change, the attributions and impacts of weight change, and the barriers to and support for weight management. Confidence was high for the first finding and moderate for the other two.
Conclusion: Interpretations of weight change among people living with HIV are shaped by prior illness experiences, beliefs about antiretroviral therapy, and prevailing sociocultural norms, and may, in turn, affect psychosocial well-being, physical health, and treatment-related behaviors. HIV care should integrate routine monitoring of weight and metabolic risk with sustained, individualized support. Because this synthesis captures participants’ perceptions and causal attributions, it does not establish that ART, any individual antiretroviral agent, or a specific regimen caused the reported weight changes.
Systematic review registration: PROSPERO , CRD420261425511.
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BibTeX
@article{zhang2026experiences,
title = {{Experiences and perceptions of weight change among people living with HIV receiving antiretroviral therapy: a qualitative systematic review and meta-synthesis}},
author = {Shuhao Zhang and Jiahao Gao and Yin Liu and Xuesong Jiang},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1947513},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1947513/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Experiences and perceptions of weight change among people living with HIV receiving antiretroviral therapy: a qualitative systematic review and meta-synthesis
AU - Shuhao Zhang
AU - Jiahao Gao
AU - Yin Liu
AU - Xuesong Jiang
PY - 2026
DA - 2026/10/27
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1947513
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1947513/full
AB - Background: With improved survival following the widespread use of antiretroviral therapy (ART), weight change has become an important concern in the long-term care of people living with HIV. Weight loss and gain may carry medical, psychological, and sociocultural meanings and may influence body image, treatment perceptions, ART adherence, and weight-management behaviors. This review synthesized qualitative evidence on experiences and perceptions of weight change among people living with HIV receiving ART. Methods: A systematic search of PubMed, Embase, Web of Science, Scopus, CINAHL, ProQuest, PsycINFO, China National Knowledge Infrastructure, Wanfang Data, VIP Database, and the Chinese Biomedical Literature Service System was conducted from database inception to June 2026 to identify qualitative studies examining experiences of weight change among people living with HIV receiving antiretroviral therapy. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Findings were synthesized using JBI meta-aggregation, and confidence was evaluated using CERQual. Results: Seven studies were ultimately included, from which 57 findings were extracted, grouped into 12 categories, and synthesized into three overarching findings: the multiple meanings of weight change, the attributions and impacts of weight change, and the barriers to and support for weight management. Confidence was high for the first finding and moderate for the other two. Conclusion: Interpretations of weight change among people living with HIV are shaped by prior illness experiences, beliefs about antiretroviral therapy, and prevailing sociocultural norms, and may, in turn, affect psychosocial well-being, physical health, and treatment-related behaviors. HIV care should integrate routine monitoring of weight and metabolic risk with sustained, individualized support. Because this synthesis captures participants’ perceptions and causal attributions, it does not establish that ART, any individual antiretroviral agent, or a specific regimen caused the reported weight changes. Systematic review registration: PROSPERO , CRD420261425511.
SN - 2296-2565
ER -