Physical Activity, Positive Coping, and Psychological Distress Among People Living with HIV/AIDS in Henan, China: A Moderated Mediation Analysis

This study aims to investigate the mediating role of positive coping in the relationship between physical activity and psychological distress (PD) among people living with HIV/AIDS (PLWHA) in Henan, China, and to explore the moderating factor regarding this relationship. A cross-sectional study was conducted among 517 PLWHA, recruited from four cities in Henan province. Path analysis was employed to examine the mediating effect of positive coping in the link between physical activity and PD. Additionally, a moderated mediation analysis was performed to assess the moderated effect on this relationship. The indirect effect of physical activity on PD via positive coping was statistically significant (β = -0.02, SE = 0.01, 95% confidence interval (CI) [-0.04, -0.01], < 0.05), confirming partial mediation. The total effect of physical activity on PD was significant (β = -0.10, SE = 0.03, 95% CI [-0.16, -0.04], < 0.05). Infection duration moderated the mediation effect, with a stronger impact of positive coping on reducing PD observed in participants with an infection duration of less than 10 years (β = -0.52, SE = 0.16, < 0.001 for <5 years; β = -0.38, SE = 0.12, < 0.001 for 5-10 years). Physical activity plays a pivotal role in reducing PD among PLWHA by promoting positive coping mechanisms. These findings highlight the importance of incorporating physical activity interventions early in the disease progression, as this may enhance coping skills and mitigate PD.