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Background  People aging with HIV are living with increased risk for functional decline compared with uninfected adults of the same age. Early preclinical changes in biomarkers in middle-aged individuals at risk for mobility and functional decline are needed.    Objective  This pilot study aims to compare measures of free-living activity with lab-based measures. In addition, we aim to examine differences in the activity level and patterns by HIV status.    Methods  Forty-six men (23 HIV+, 23 HIV−) currently in the MATCH (Muscle and Aging Treated Chronic HIV) cohort study wore a consumer-grade wristband accelerometer continuously for 3 weeks. We used free-living activity to calculate the gait speed and time spent at different activity intensities. Accelerometer data were compared with lab-based gait speed using the 6-minute walk test (6-MWT). Plasma biomarkers were measured and biobehavioral questionnaires were administered.    Results  HIV+ men more often lived alone ( P =.02), reported more pain ( P =.02), and fatigue ( P =.048). In addition, HIV+ men had lower blood CD4/CD8 ratios ( P <.001) and higher Veterans Aging Cohort Study Index scores ( P =.04) and T-cell activation ( P <.001) but did not differ in levels of inflammation ( P =.30) or testosterone ( P =.83). For all participants, accelerometer-based gait speed was significantly lower than the lab-based 6-MWT gait speed ( P <.001). Moreover, accelerometer-based gait speed was significantly lower in HIV+ participants ( P =.04) despite the absence of differences in the lab-based 6-MWT ( P =.39). HIV+ participants spent more time in the lowest quartile of activity compared with uninfected ( P =.01), who spent more time in the middle quartiles of activity ( P =.02).    Conclusions  Accelerometer-based assessment of gait speed and activity patterns are lower for asymptomatic men living with HIV compared with uninfected controls and may be useful as preclinical digital biomarkers that precede differences captured in lab-based measures.

Middle-Aged Men With HIV Have Diminished Accelerometry-Based Activity Profiles Despite Similar Lab-Measured Gait Speed: Pilot Study