Some people living with HIV experience weight gain or loss after initiating or switching antiretroviral therapy (ART) regimens. There is limited research on how perceptions of weight change affect health behaviors in this population. We interviewed 61 people living with HIV (aged 23–65; 51% cisgender men, 36% cisgender women, 13% transgender/nonbinary; 87% Black and/or Hispanic) in New York City about their feelings about weight change. Using an inductive thematic approach, we identified four themes: weight changes were attributed to external and internal factors; weight management was seen as an individual responsibility; feeling in control of one’s health was linked to body image satisfaction; and one’s sense of control related to health behaviors in divergent ways. Low perceived control could interfere with recommended behaviors, but some long-term survivors focused on controlling what they could. Healthcare providers should consider HIV patients holistically and be aware of ART’s impact in their daily lives.
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