Not long ago, an HIV diagnosis often came with a grim outlook. With so much focus on managing symptoms and urgent medical decisions, exercise was rarely part of the conversation. Today, HIV is considered a manageable chronic condition. With effective antiretroviral therapy (ART), most people living with HIV can expect to live close to the life expectancy of anyone else. Living longer means thinking long-term, and that’s where exercise becomes a critical piece of the puzzle.
According to the American Heart Association, people living with HIV are at higher risk for chronic conditions such as cardiovascular disease, insulin resistance, and metabolic disorders. Some HIV medications can also lead to weight gain or changes in fat distribution, which may further increase those risks. For people living with HIV, exercise is an essential part of staying healthy over time. In this post, we explore the why and how of HIV fitness, with guidance for anyone ready to take charge of their health through movement.
Why Exercise Matters for People Living with HIV
Managing HIV is a daily reality, but so is building a strong, active body. While ART does a lot to keep the virus in check, exercise gives your immune system and overall health an extra boost. Staying active can help you:
- Strengthen your immune response
- Build muscle and stay physically capable
- Manage fatigue and improve mood
- Keep your heart and lungs in shape
- Maintain a steady, healthy weight
- Sleep better and boost your energy
Moderate aerobic and resistance exercise significantly improved immune markers like CD4+ cell counts in people living with HIV. Even small changes (like walking 30 minutes a day or lifting light weights a few times per week) can make a measurable difference.
The Connection Between HIV, Immunity, and Movement
Your immune system defends you from infections, and HIV puts extra stress on this system by targeting certain white blood cells. But exercise can help support and strengthen what’s working well. Here’s how.
1. Helps Your White Blood Cells Do Their Job
White blood cells patrol your body looking for viruses, bacteria, and other threats. Exercise improves circulation, allowing these cells to travel and react more quickly. Essentially, it gives your body a better shot at fighting off infections.
2. Reduces Ongoing Inflammation
Studies have shown that exercise lowers certain markers in the blood, such as CRP (C-reactive protein) and IL-6, both of which are linked to chronic inflammation. Keeping these levels down can help your body focus on fighting infections, not just managing background stress.
3. Lowers Stress
High stress means higher cortisol levels, and too much cortisol can wear down your immune system over time. Exercise helps bring those stress hormones back down to a healthier range.
4. Improves Your Body’s Response to ART
Physical activity can help your body handle HIV medications more efficiently. It also supports your liver and kidneys, which process these meds, and may ease side effects like fatigue or unwanted weight changes.
Strength Building: The Importance of Muscle Mass with HIV
Before effective HIV meds, wasting syndrome was a real problem. The virus would burn through major muscle groups for fuel, leaving people weak, thin, and visibly unwell. Modern medications keep that from happening. Still, muscle loss and building muscle may be bigger challenges for people with HIV than for others. But it’s not entirely out of reach, and the benefits of strength training exercises go way beyond appearances. Just a little bit of strength work each week can go a long way. It helps:
- Lower your risk of falls and frailty as you age
- Keep your bones strong and reduce fracture risk
- Improve how your body handles sugar and supports heart health
- Fire up your metabolism, so you’ve got more energy and better weight control
Building a Safe and Effective HIV Fitness Routine
It’s best to talk to your healthcare provider before starting any new exercise program, especially if you’re managing other health concerns like high blood pressure, neuropathy, or heart conditions. Once you’re cleared, here’s what you can do.
1. Start with What Feels Manageable
Don’t pressure yourself to do too much at first. Short walks, bike rides, or gentle yoga for 10-15 minutes a few times a week is a great place to start. You can also try bodyweight exercises, like wall push-ups, squats, or resistance bands. Find what feels good and add a little more as you build confidence.
2. Work Toward 150 Minutes a Week
The general guideline is about 150 minutes of moderate aerobic activity per week, plus two days of strength work. While it may sound like a lot, think of it as 20 to 30 minutes a day, five days a week. You could take a brisk walk around the neighborhood, join a dance class, go swimming, or ride a bike. Anything that gets your heart rate up a bit and makes you breathe a little heavier is valid.
3. Focus on Weight Training Correctly
You don’t need a gym membership or heavy equipment. Use your body weight, household objects, or resistance bands for strength training. If you try weights, begin light and focus on good form before adding more.
4. Make Time for Rest and Recovery
Rest is just as important as movement. Your muscles need time to recover, and so does your immune system. Stretch after every workout to reduce soreness and improve flexibility. Take at least one or two full rest days each week where you let your body recharge. You can still move on those days (maybe a walk, some deep breathing, or gentle stretching), but keep it light and easy.
Why Many People with HIV Don’t Exercise
Despite all its benefits, many people living with HIV aren’t getting regular exercise. Some don’t feel comfortable in their bodies or think they don’t “fit in” at the gym. Others feel the weight of stigma and prefer to avoid public spaces altogether. Lack of support can make it even harder.
If public gyms aren’t your thing, try exercising at home or in a park. Ask a friend or family member to join you for a walk or a short workout. Moving together adds motivation and makes it easier to stick with it.
Money is another barrier for many. Roughly one-third of people living with HIV in the U.S. are close to or below the poverty line. But exercise doesn’t have to be expensive. Walking, dancing, and bodyweight exercises can all be done for free. There are also plenty of free online workout videos designed for different fitness levels and needs.
Mental Health, Motivation & Exercise
Living with HIV can take a toll on mental health. Depression, anxiety, and social isolation are common, and these struggles can also sap your motivation to move. But the relationship goes both ways. Physical activity is proven to boost mood, increase serotonin and endorphins, and help manage symptoms of depression and anxiety. People who stay active notice:
- Reduced depression and anxiety symptoms
- Better self-image and confidence
- Increased motivation and sense of control
Better yet, many community centers and HIV support organizations offer movement-based programs, group fitness classes, or walking clubs. These programs are a great way to workout and meet people who get what you’re going through.
Special Considerations for HIV Fitness
Everyone’s experience with HIV is different, so it’s okay to adjust your workouts based on how you feel and what your body needs.
1. Energy Levels Can Shift
HIV itself, along with certain medications, can affect your energy levels from day to day. If you’re feeling wiped out, don’t push yourself to power through. Opt for gentle stretching, walking, or a short mobility session instead.
2. Watch Out for Nerve Pain or Numbness
Peripheral neuropathy (nerve pain, tingling, or numbness in your hands and feet) can make some types of exercise feel difficult or risky. If this is something you’re dealing with, choose low-impact activities that put less pressure on your joints and feet.
3. Pay Attention to Immune Health
In case your CD4 count is very low or you’re dealing with an opportunistic infection, your provider may recommend postponing intense physical activity until you’ve stabilized.
Movement is Medicine
Exercise is a form of self-care. Whether you’re walking, dancing, stretching, or lifting, you’re sure to feel stronger, more balanced, and more in control of your health. Side by Side is here to support your journey. We offer HIV care coordination and connect you to local resources in Marion County. Our team can help you find the help you need at any stage.
Remember: You don’t have to do it alone
Reach out to us today.
