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Description: Since the reporting of Human Immunodeficiency Virus (HIV) at least four decades ago, there has been advancements in Antiretroviral Therapy (ART), prolonging the longevity of People Living with HIV (PLWH). The improved health outcomes and longevity of PLWH also comes with additional risks of developing age-related chronic illnesses such as Type 2 Diabetes and Hypertension. Studies have shown that among OPLWH physical activity interventions significantly increase walking capacity and reduce abdominal adiposity (Shim & Noh 2022). In addition, physical activity and dietary interventions can reduce the risks of developing Type 2 Diabetes (Duncan et al., 2020). Despite the advantages of physical activity OPLWH have low levels of physical activity (Vancampfort et al., 2018). In this regard, this scoping review seeks to describe the challenges faced by OPLWH in performing physical activity. Physical activity is defined as all bodily movement made by skeletal muscles resulting in energy expenditure (Caspersen et al., 1985). Exercise forms part of physical activity and is repetitive, structured physical activity that is planned to ensure fitness (Caspersen et al., 1985). To ensure the benefits discussed by Duncan et al (2020); Shim and Noh (2022), physical activity ought to be regular and of adequate intensity (Bull et al., 2020). In this regard, the World Health Organisation outlined Guidelines for Physical Activity and Sedentary Life (2020) delineating adequate physical activity levels for older people living with chronic illnesses such as HIV. The guidelines broadly recommend performance of moderate intensity aerobic physical activity for 150-300 minutes weekly or 75-150 minutes of vigorous intensity aerobic physical activity. Alternatively, a combination of both moderate and vigorous intensity physical activity. (Bull et al., 2020). The guidelines also stipulate that physical activity should include muscle strengthening exercises of all muscle groups for two days a week and physical activity should be multicomponent to assist with fall prevention (Bull et al., 2020). Despite the publication of the guidelines for physical activity and sedentary lifestyle, OPLWH fail to meet physical activity level requirements due to several factors. In a longitudinal study conducted in Uganda, the presence of frailty and co-morbidities were associated with low levels of physical activity among OPLWH (Ratnayke et al., 2025). Furthermore, Ratnayke et al. (2025) found that OPLWH were less physically active than older people in the general population living without HIV. The low levels of physical activity among OPLWH are attributed to a combination of ageing in the presence of HIV (Debeaudrap et al., 2024). Although OLPWH are associated with lower levels of physical activity, they are a heterogenous population who vary in terms of demographic characteristics such as age, gender and place of residence. These demographic variations in turn influence physical activity patterns presenting new challenges. For example, a study in the USA reported that women had lower levels of physical activity (Cherenack et al., 2020). In addition, OPLWH also vary regarding their viral suppression and or presence of co-morbidities which also affects their physical activity patterns. Considering this, a study in Uganda found that OPLWH with multimorbidity are most likely to have lower physical activity levels (Ratnayake et al., 2025). Therefore, considering the low levels of physical activity among OPLWH, and their increased risks of developing age-related chronic illness. This scoping review of literature will describe the challenges experienced by OPLWH in physical activity performance. Prior to conducting the scoping review, a search of the databases, PubMed, Google Scholar and Science to direct will be done to ensure that no similar review has been conducted Methods The Johanna Briggs Institute (JBI) framework for conducting scoping reviews of literature will be used to conduct the scoping review as described by Peters et al. (2022). The framework includes 5 main steps: (1) identifying the research question, (2) identifying the relevant studies, (3) study selection, (4) charting the data, (5) collating summarising and reporting results and (6) consultation. Step 1: Identifying the research question The study seeks to describe the challenges experienced by OPLWH in physical activity performance. Therefore, the main research question will be: What are the challenges experienced by OPLWH in physical activity performance? Peters et al. (2022) also note that in identifying the research question, researchers ought to consider the Population, Context and Concept (PCC) framework. In line with this, this study will make the following considerations in developing the research questions 1. Population: inclusion of studies that only describe OPLWH. Rationale: Characteristics of the OPLWH will reflect their heterogeneity. 2. Context: inclusion of studies in all contexts that OPLWH were recruited from. This will include primary healthcare clinics, community settings, tertiary hospitals, not-for profit organisations, care facilities and district public and private hospitals. The study will also include OPLWH who are recruited from rural and urban areas. Rationale: the inclusion of OPLWH from all contexts enables the understanding of where challenges of physical activity performance occur 3. Concept: The review will include studies that describe the challenges experienced by OPLWH in physical activity performance. Therefore, the main research question will be: What are the challenges experienced by OPLWH in physical activity performance. Sub questions will include: 1. In what contexts do older PLWH experience physical activity challenges 2. What are the characteristics of OPLWH who experience challenges in physical activity performance. Step 2: Identifying relevant studies To search for the studies, an initial search of two databases (PubMed and Google Scholar) will be done. From these two initial databases, studies retrieved will be analysed using titles and abstracts. The second step will include a full search across all databases using all key words. This search will include PubMed, ScienceDirect, Ovid, and Google Scholar. Keywords that will be used in searching for literature are challenges, physical activity/exercise, older people HIV. The last search will include a search of the reference lists of all the studies identified. This search of the reference lists will also include a search of related articles. The inclusion and exclusion criteria. The types of sources which will be included are: • Studies conducted from 2014-2024 • Studies in English • Articles should have an original research design. The review will exclude articles: • Not written in English • Systematic reviews, book chapters, editorials or commentaries • During the search a librarian will also be consulted. Step 3: Selecting the studies The literature search is expected to be iterative and will be conducted by two reviewers. The first reviewer will select the studies. At least 10% of these will be submitted to the second reviewer any concerns will be discussed between the two reviewers. The first reviewer will then address the concerns of the second reviewer and submit to the second reviewer who will review not less than 10% of the newly selected list. The first reviewer will then address the concerns of the second reviewer a second time and a final selection list of articles will be drawn. Step 4: Charting the data To chart the data, Microsoft excel will be used. This step will include extracting data on the following: • Study title • Context/setting where the study was conducted • Year of publication • Ages of the OPLWH included, that is the characteristics of the OPLWH • Research approaches and designs • Objectives of the study • Outcomes aligned to the scoping review • Study population and sample size. Step 5: Collating and summarising the data To analyse the data, a numerical analysis will be conducted first which will be followed by a content analysis. The numerical analysis will be done using descriptive statistics outlining the percentage of articles by year, geographical location and type of research approach. Microsoft Excel will be used to conduct the numerical analysis. Tables will be used to present the numeric analysis. Qualitative content analysis will also be done to describe the context, characteristics and concept. In this regard, a narrative analysis will be done to describe the characteristics of OPLWH who experience challenges in physical activity performance, the contexts which the OPLWH experience the challenges and the challenges in physical activity performance among OPLWH. References 1. Bull, F.C., Al-Ansari, S.S., Biddle, S., Borodulin, K., Buman, M.P., Cardon, G., Carty, C., Chaput, J.P., Chastin, S., Chou, R. and Dempsey, P.C., 2020. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British journal of sports medicine, 54(24), pp.1451-1462. 2. Caspersen, C.J., Powell, K.E. and Christenson, G.M., 1985. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public health reports, 100(2), p.126. 3. Cherenack, E.M., Stein, M.D., Abrantes, A.M., Busch, A., Pinkston, M.M., Baker, J.V. and Uebelacker, L.A., 2023. The relationship between substance use and physical activity among people living with HIV, chronic pain, and symptoms of depression: a cross-sectional analysis. AIDS care, 35(2), pp.170-181. 4. Debeaudrap, P., Etoundi, N., Tegbe, J., Assoumou, N., Dialo, Z., Tanon, A., Bernard, C., Bonnet, F., Aka, H. and Coffie, P., 2024. The association between HIV infection, disability and lifestyle activity among middle-aged and older adults: an analytical cross-sectional study in Ivory Coast (the VIRAGE study). BMC Public Health, 24. 5. Duncan, A.D., Peters, B.S., Rivas, C. and Goff, L.M., 2020. Reducing risk of Type 2 diabetes in HIV: a mixed‐methods investigation of the STOP‐Diabetes diet and physical activity intervention. Diabetic Medicine, 37(10), pp.1705-1714. 6. Peters, M.D., Marnie, C., Tricco, A.C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C.M. and Khalil, H., 2020. Updated methodological guidance for the conduct of scoping reviews. JBI evidence synthesis, 18(10), pp.2119-2126. 7. Ratnayake, A., Tong, Y., Reynolds, Z., Chamut, S., Quach, L. T., Mbabazi, P., Sagar, S., Maling, S., North, C. M., Passell, E., Yoo-Jeong, M., Tsai, A. C., Paul, R., Ritchie, C. S., Seeley, J., Hoeppner, S. S., Atwiine, F., Tindimwebwa, E., Okello, S., Nakasujja, N., … Olivieri-Mui, B. (2025). Longitudinal Trends in Physical Activity Among Older Adults With and Without HIV in Uganda. Journal of aging and health, 8982643251314064. Advance online publication. https://doi.org/10.1177/08982643251314064 8. Ratnayake, A., Tong, Y., Reynolds, Z., Chamut, S., Quach, L.T., Mbabazi, P., Sagar, S., Maling, S., North, C.M., Passell, E. and Yoo-Jeong, M., 2025. Longitudinal Trends in Physical Activity Among Older Adults With and Without HIV in Uganda. Journal of aging and health, p.08982643251314064. 9. Shim, M.S. and Noh, D., 2022. Effects of physical activity interventions on health outcomes among older adults living with HIV: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 19(14), p.8439. 10. Vancampfort, D., Mugisha, J., Richards, J., De Hert, M., Probst, M. and Stubbs, B., 2018. Physical activity correlates in people living with HIV/AIDS: a systematic review of 45 studies. Disability and rehabilitation, 40(14), pp.1618-1629.