Decades ago, being diagnosed with HIV meant illness and a shorter life. Exercise wasn’t even part of the conversation.
Today HIV is more of a lifelong than a life-threatening disease.
“In large part, because of the good drugs we have now, the lifespan of people with HIV is close to that of people without HIV,” says Dr. David Hardy, scientific and medical advisor to the American Academy of HIV Medicine.
That makes exercise an essential part of the conversation. Living longer means taking care of your body in the long run.
“Exercise is medicine,” says exercise physiologist Joe Cannon. “It relieves depression, stimulates your immune system, and can make your microbiome or the bacteria that live in your colon healthier. If you could put exercise in a pill, everyone would take it. “
Benefits of exercise for people with HIV
People who are HIV positive are more likely than others to have diabetes, heart disease, and risk factors for these diseases. Also, a possible side effect of some HIV medications is weight gain, which can further increase your risk for these conditions.
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All of this means that the benefits of exercise are just as important (or more important) to you as they are to anyone else. Exercise brings everyday and long-term benefits.
Daily physical activity can:
- Raise your mood
- Help you focus
- Keep stress low
- Make your sleep more restful
All of these are important for continued good health.
Over time, exercise will help you:
Move more
Despite the many benefits of exercise, a significant number of people with HIV do not.
“Some people don’t feel good about their own bodies and think gyms are only for the beautiful people,” says Cannon. He says the stigma some people feel from HIV could keep them from going to the gym or getting out of the gym and being active. A lack of social support can also hold them back.
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If you are uncomfortable in public places, ask a friend or family member to exercise with you. This provides support and makes you responsible for fitness to other people.
Often times, money is another concern. “Thirty to 35% of people with HIV live at or just above the federal poverty line,” says Hardy.
But fitness doesn’t have to cost anything. And it doesn’t require a gym.
A solid exercise program consists of only three parts:
“Start with 1 to 2 days a week, 20 to 30 minutes at the beginning, and then gradually increase to 3 to 4 days a week,” suggests Cannon. “This minimizes the pain you feel after exercising or doing activities that you are not used to.”
Strength versus muscle
Before effective HIV therapy, wasting syndrome was a challenge. The disease uses your muscle tissue as a source of energy.
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“Untreated HIV infection is a very active and calorie-burning process,” says Hardy. “The body would burn muscle tissue, and people wasted and looked very sick.” Today HIV drugs prevent this.
Still, muscle wasting and building can be more challenging for people with HIV than for others. One small study showed that older adults with HIV lose muscle just as quickly as anyone their age. But when they tried to build muscle through an exercise program, they didn’t gain 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 are not the same thing,” says Cannon. “We care a lot about what we can see in the mirror, but a lot of things happen at the cellular level.”
If you’re just starting out, Cannon suggests a number of strength training exercises.
“In order for muscles to grow, you have to put some kind of stress or resistance on them,” he says. “A set of strength training exercises like machines, dumbbells, resistance bands, or body weight exercises will build strength. It will take 8 to 12 weeks for your body to adjust. Do not rush to get three sentences. One set will build strength and endurance. You can get stronger, but you can’t look like a bodybuilder. “
Building muscle with nutritional supplements
Diet supplements like animal or vegetable protein powder, creatine, and beta-hydroxymethylbutyrate (HMB) can help you build and maintain muscle. Most, with one exception, have no drug interactions with HIV.
“One class of HIV drugs that we now rely heavily on are integrase inhibitors,” says Hardy. “If a dietary supplement contains calcium, magnesium, iron or aluminum, it can make this HIV drug less effective.”
Ask your doctor before taking any supplements. If you are looking to take a supplement containing any of these items, your doctor may suggest that you clear it out 2 to 6 hours before or after taking your medication. That way, they won’t both be in your stomach at the same time.
What about opportunistic infections?
You can take on weights at the gym, but you won’t encounter an opportunistic infection (OI). That’s because OIs come from inside you, not from sweaty surfaces.
“OIs come from bacterial, fungal, or parasitic infections that our bodies are already carrying,” says Hardy.
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In people with healthy immune systems, the body holds these infections in check and they never develop into disease. But in people who haven’t treated HIV or whose drugs 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 by taking your HIV medication.
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