The benefits of exercise for people living with HIV

What is the role and importance of exercise for HIV-positive people?

Exercise helps HIV-positive people control some of the long-term side effects of HIV treatment.

Is exercise good for HIV-positive people?

Exercising is important, whether you are HIV-positive or HIV-negative. Regular exercise is part of a healthy lifestyle.

Different types of exercise are appropriate depending on where an individual is in their HIV treatment progression. Exercise plays a role in controlling some of the long-term side effects, such as altered body composition and elevated cholesterol, triglycerides and blood glucose.

Exercise benefits for HIV patients

• Maintains or builds muscle mass and decreases fat, helping to maintain a healthy body weight
• Reduces cholesterol and triglyceride levels (less risk of heart disease)
• Increases energy
• Regulates bowel function
• Strengthens bones (less risk of osteoporosis)
• Improves blood circulation
• Increases lung capacity
• Helps with sound, restful sleep
• Lowers stress and can improve depression
• Improves appetite
• Reduces the risk of high blood pressure, diabetes, and some kinds of cancer

Moderate exercise improves cardiovascular and nervous system function in individuals living with HIV. Studies have shown that moderate exercise three times a week, at a session duration of 45 minutes each, over 10 weeks, significantly improves the nervous system and blood circulation in people living with HIV.

Before starting any exercise programme, speak to your healthcare provider to confirm if there should be any limitations on your activities. When you’re feeling really unwell you shouldn’t exercise. Differentiate between general malaise (generally feeling unwell, physically or emotionally) and serious fatigue or illness.

If you’re feverish, dizzy, have swollen joints, pain in your feet or hands, vomiting, diarrhoea, open sores, bleeding gums, or blood in the urine or stool, don’t exercise. Listen to your body! If you get overly tired in the middle of a workout, it’s time to stop. Be flexible and patient with both your body and your workout.

Exercise routine for HIV-positive people

If you were already committed to a regular exercise routine before you being diagnosed with HIV, here’s the good news: keep doing what you were doing. We do know, however, that living through the first few months of treatment may make it difficult to stay committed to your exercise goals. That’s okay: living a good, healthy life means taking a break sometimes.

If you’re too tired to exercise, or need to de-prioritise hitting the gym for a while, it’s absolutely fine. Before you start a new exercise routine, however, we insist you speak to your doctor first. Nobody – no matter his/her health, HIV status, or lifestyle, should start a new exercise programme without the advice of a doctor, nurse or clinician.

How to start exercising

If you’re not a regular at the gym, or you prefer exercising at home, we’ve got good news for you: that’s totally okay! There are a wide variety of exercises you can do at home, and most of them can be done in a group, or with your family. If you’re just getting started into a regular exercise routine, or you’re starting up again, here’s what we recommend:

• Aim for 20-30 minutes of exercise, at least 3 times a week, when you’re starting out.
• Work your way up to 45 minutes of exercise, at least 3-4 times a week, over a few months.
• Don’t throw yourself into a hectic exercise routine straight away. You could strain your heart, and stress yourself out. Moreover, you could injure yourself early on, and that’ll put you out of action for longer.
• Set yourself some goals. Setting yourself some small goals, to achieve over a period of time, can be extremely motivating. Don’t set any big goals just yet. You’re just getting back into this exercise thing: be kind to your body.

Different types of exercises for people living with HIV

Getting the right amount of regular exercise is important, no matter your HIV status. While it’s not always possible to hit the gym or join an exercise class, getting that necessary exercise is easy enough to do at home. We recommend:

• Walking: Walking is one of the most beneficial exercises you can do. Turn it into a family exercise, and enjoy an after-work walk together. Alternatively, you can join a neighbourhood walking group. Find one online, or ask around to see if anyone in your neighbourhood would be keen to start one.
• Dancing: Yes! This is your excuse to turn up the music and get down in the lounge every evening. Dancing is a fun way to exercise, and a regular dance party that works up a sweat is brilliant for your body, and your mind.
• Learn to ride a bicycle: If you haven’t learnt yet, now’s the time. Taking a bike ride is a fun way to work off the stresses of your day, and get where you need to go. Make sure you wear all the appropriate safety gear too!
• Go swimming: Swimming is considered a resistance exercise, and so very good for your heart and lungs. A regular dip in the pool, whether at home or at a public facility, can be very good for your health.
• Find something to follow on YouTube: If you’re interested in starting a new type of exercise, but aren’t entirely sure where to begin, give YouTube a search. There are thousands of instructional videos on YouTube, freely accessible, that can guide you through beginning Yoga, learning how to exercise at home, or simply learning a new skill.
• Weight training & cardiovascular exercise: If you have joined a gym, or hired a personal trainer, focus on weight training and cardiovascular exercise, as a way to increase your lean body mass and improve your bone density. Losing body mass and bone density are common side effects of living with HIV. Start slowly – very slowly – with this, and be sure to check in with your doctor, nurse or clinician as you progress.

How does CD4 count affect which exercises you can do?

Fitness is divided into several different components, all of which are important to a person living with HIV. These components are resistance training, cardiovascular training, flexibility training, balance training, and mind-body training. Asymptomatic Individuals with HIV (CD4 count over 500 cells/mL) may start working out two or three times per week for 20-30mins at the easy level. Over the next several weeks, consider increasing the time up to 30mins, but probably not over 60mins per session. Do this for up to five times per week, working mostly in the moderate range but every so often going into the difficult range (not staying there for long).

Symptomatic Individuals with HIV (CD4 count ranging from 200-500 cells/mL) may start off working out up to three times per week in the easy range, for 15-20mins or as tolerated. Some days you may be able to go longer and other days, not. As you get stronger, you may be able to gradually move up into the moderate range for as long as 40mins per session, up to four times per week.

Monitor yourself and don’t over-train. If you are overly fatigued or exhausted, take a couple of days off to recover. Then start exercising again at a slightly lower intensity. Individuals living with AIDS will want to begin very gently. You might workout up to 15-20mins, up to three times per week as tolerated. You should progress cautiously over the next several weeks up into the moderate range for 20-30mins three times per week at the most. The rule of thumb here is to do what you can do, and not overdo it. Be aware of your fatigue and exhaustion level and stop before you reach critical.

For more advice on how to exercise when you’re HIV-positive, chat to your doctor, or call our 24-hour HIV helpline. We believe in you!

Sources:

NAM aidsmap. 2015. Exercise. [online] Available at: <http://www.aidsmap.com/about-hiv/exercise> [Accessed 8 August 2020].

The Aids Infonet. 2016. Exercise And HIV. [online] Available at: <http://www.aidsinfonet.org/fact_sheets/view/802> [Accessed 8 August 2020].

The Well Project. 2019. Physical Activity, Exercise, And HIV. [online] Available at: <https://www.thewellproject.org/hiv-information/physical-activity-exercise-and-hiv> [Accessed 8 August 2020].

UC San Diego Health. 2020. Diet And Exercise For HIV-Positive Individuals. [online] Available at: <https://health.ucsd.edu/specialties/hiv/hiv-health/Pages/diet-exercise.aspx> [Accessed 8 August 2020].

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