Acceptability and feasibility of fitness watches to monitor sleep and physical activity among women living with HIV: broadening the approach to optimizing cardiovascular health.

Background: Women with HIV have increased risk of cardiovascular disease compared to women without HIV. Adopting healthy lifestyle habits in early adulthood, including adequate sleep and physical activity, can mitigate this risk. Fitness watches provide objective measures of sleep and physical activity, and may enable proactive interventions to optimize long-term cardiovascular health. However, the acceptability and feasibility of wearable devices for continuous monitoring of these two measures among women living with HIV has not been adequately explored. Methods: A pilot acceptability and feasibility study was conducted with thirty women with HIV participating in a US-based prospective observational study. Participants were assigned to one of three fitness watches, two requiring data transfer every 3-5 days, and one without a transfer requirement. Acceptability of using the fitness watch and feasibility of collecting sleep and physical activity data were assessed. Results: Among the 30 women, median participant age was 36.0 years (Interquartile Range: 30.1, 40.3) with 8 (27%) having > a high school education, and 19 (63%) never having owned a fitness watch. All participants agreed or strongly agreed that the device was easy to use, regardless of device type. Over 80% found it acceptable to collect and share sleep and physical activity data. Only three (10%) participants reported data transfer to be somewhat difficult. Sleep and physical activity data collection was feasible for 90% of devices requiring interim data transfer and 100% of devices without a transfer requirement. Conclusions: All three fitness watches demonstrated high acceptability and feasibility for continuous data collection among women living with HIV, including participants without prior experience using wearable devices, with minimal concerns regarding privacy or confidentiality. Participants expressed a preference for devices that provided real-time access to personal data, suggesting that user visibility of health metrics may enhance engagement with sleep and physical activity interventions. These findings may inform the design and implementation of wearable device-based interventions to support sleep health and physical activity among women living with HIV of reproductive age.