Decades ago, an HIV diagnosis meant sickness and a shorter life. Exercise wasn’t even part of the conversation.
Today, HIV is more of a lifelong disease than a life-threatening one.
“In large part, due to the good medications we have now, the lifespan for people with HIV is close to that of people without HIV,” says David Hardy, MD, a scientific and medical consultant for the American Academy of HIV Medicine.
That makes exercise an essential part of the conversation. Living longer means taking care of your body for the long haul.
“Exercise is medicine,” says exercise physiologist Joe Cannon. “It offsets depression, stimulates your immune system, and can make your microbiome, or the bacteria that live in your large intestines, healthier. If you could put exercise in a pill, everyone would take it.”
Benefits of Exercise for People Who Have HIV
People who are HIV-positive are more likely than others to have diabetes, heart disease, and risk factors for these conditions. Also, a possible side effect of some HIV medications is weight gain, which can further raise your risk for these conditions.
This all means that the benefits of exercise are just as important (or more so) for you as they are for anyone else. Exercise brings day-to-day and long-term benefits.
Daily physical activity can:
- Boost your mood
- Help you focus
- Keep stress levels low
- Make your sleep more restorative
All of these are important for ongoing good health.
Over time, exercise helps you:
- Reach or maintain a healthy weight
- Avoid health problems like diabetes and cardiovascular disease
- Lower your risk for some cancers
- Avoid the higher risk of death that comes with these diseases
Despite the many benefits of exercise, a significant number of people who have HIV don’t do it.
“Some people don’t feel good in their own body and think gyms are only for the beautiful people,” Cannon says. He says the stigma some people feel from having HIV may keep them from gyms or from getting out and being active. A lack of social support may hold them back, too.
If you don’t feel comfortable in public facilities, ask a friend or family member to work out with you. This provides support and makes you accountable to someone else for getting fit.
Money is often another concern. "Thirty to 35% of people with HIV live at or just above the federal poverty line," Hardy says.
But fitness doesn’t have to cost anything. And it doesn’t require a gym.
A solid exercise program has just three parts:
- Stretches to keep you flexible
- Strength training with free weights or your body weight
- Aerobic exercise like walking or cycling
“Start with 1 to 2 days a week, 20 to 30 minutes at the beginning, then gradually up it to 3 to 4 days a week,” Cannon suggests. “This will minimize the pain you feel after exercise or activity you’re not used to.”
Strength vs. Muscle
Before effective HIV therapy, wasting syndrome was a challenge. The disease uses your muscle tissue as a source of energy.
“Untreated HIV infection is a very active and calorie-burning process,” Hardy says. “The body would burn muscle tissue, and people wasted and looked very ill.” Today, HIV medications keep that from happening.
Still, muscle loss and building muscle may be bigger challenges for people with HIV than for others. One small study showed that older adults with HIV lose muscle at the same rate as anyone else their age. But, when they tried to build muscle through an exercise program, they didn’t build as much as people who are HIV-negative.
But don’t be discouraged. The benefits of exercise go beyond what you can see.
“Muscle mass and strength aren’t the same thing,” Cannon says. “We put a lot of emphasis on what we can see in the mirror, but on the cellular level, a lot of things are happening.”
If you’re just starting out, Cannon suggests one set of strength training exercises.
“For muscle to grow, you have to put it under some sort of stress or resistance,” he says. “One set of strength training exercises, like machines, free weights, resistance bands, or body weight exercises, will build strength. It’s going to take 8 to 12 weeks for your body to adapt. Don’t be in a hurry to progress to three sets. One set will build strength and endurance. You can get stronger but not look like a bodybuilder.”
Building Muscle With Supplements
Supplements like animal or plant protein powder, creatine, and beta-hydroxymethylbutyrate (HMB), may help you build and keep muscle. Most have no interactions with HIV medication, with one exception.
“One class of HIV medications we rely on very heavily now are integrase inhibitors,” Hardy says. “If a supplement contains calcium, magnesium, iron, or aluminum, it can lessen the effects of this HIV medication.”
Check with your doctor before you take any supplements. If you want to take a supplement with any of these elements, your doctor may suggest that you space it out 2 to 6 hours before or after you take your medication. That way, both of them aren’t in your stomach at the same time.
What About Opportunistic Infections?
You can pick up weights at the gym, but you’re not going to pick up an opportunistic infection (OI). That’s because OIs come from inside you, not from sweaty surfaces.
“OIs come from the bacterial, fungal, or parasitic infections our bodies are already carrying,” Hardy says.
In people with a healthy immune system, the body keeps these infections at bay, and they never develop into illness. But in people who have untreated HIV or whose medications don’t work, these infections can progress and make you sick.
OIs are less common today thanks to effective HIV treatment. The gym won’t change your risk for these infections. The best way to prevent them is to take your HIV medication.
American Council on Exercise: “Exercise and AIDS.”
David Hardy, MD, scientific and medical consultant, American Academy of HIV Medicine, Los Angeles.
U.S. National Library of Medicine, National Institutes of Health: “Weight Gain: A Possible Side Effect of All Antiretrovirals.”
HIV.gov: “Should People Living With HIV Exercise?”
Joe Cannon, exercise physiologist, Delaware County, PA.
Memorial Sloan Kettering Cancer Center: “HMB.”
CDC: “What Is AIDS?”