Background: Declining levels of physical activity at workplaces, during leisure time and when travelling, accompanied by increasing exposure to the mass media, are major determinants of the global obesity epidemic. This study aimed to assess physical activity, the body mass index (BMI) and energy intake of human immunodeficiency virus (HIV)-uninfected and HIV-infected black women in Mangaung.

Method: A random sample of 500 black women was selected in Mangaung. Physical activity levels, dietary intake and BMI were determined in younger and older women, aged 25–34 and 35–44 years, respectively.

Results: Of the 488 women who qualified for participation, 61% of the younger women and 38% of the older women were HIV-infected. Low physical activity levels were reported in most women, and more than 50% were overweight or obese. The BMI of HIV-infected younger women with low physical activity levels (24.9 kg/m2) was significantly lower than that of the HIV-uninfected younger women (27.2 kg/m2) (p-value 0.02). The energy intake of older HIV-infected women with low physical activity levels was significantly lower (10 090 kJ) than that of the older HIV-infected women in the normal to high physical activity category (14 519 kJ) (p-value 0.03).

Conclusion: A more active lifestyle and energy-reduced diet that focuses on food quality could partially address BMI parameters in HIV-uninfected women. Safeguarding a lean BMI in HIV-infected women, by increasing physical activity levels while maintaining current energy intake, with an emphasis on healthy eating practices, could support quality of life.