Decades ago, a diagnosis of HIV meant illness and a shorter life. Exercise was not even part of the conversation.

Today, HIV is more of a lifelong disease than a fatal disease.

“In large part, with the good drugs we have now, the lifespans of people living with HIV are approaching that of people without HIV,” says David Hardy, MD, scientific and medical consultant for the American Academy of HIV Medicine.

This makes exercise a vital part of the conversation. Living longer means taking care of your body over the long term.

“Exercise is medicine,” says exercise physiologist Joe Cannon. “It compensates for depression, boosts your immune system and can make your microbiome, or the bacteria that live in your large intestine, healthier. If you could put exercise in a pill, everyone would take it.

Benefits of exercise for people with HIV

People with HIV are more likely than others to have diabetes, heart disease and risk factors for these conditions. Also, a possible side effect of some anti-HIV drugs is weight gain, which can further increase your risk of developing these conditions.


All of this means that the benefits of exercise are just as important (or more) to you as they are to anyone else. Exercise brings daily and long-term benefits.

Daily physical activity can:

  • Boost your mood
  • Help you focus
  • Keep stress levels low
  • Make your sleep more restful

All of these are important for continued good health.

Over time, exercise helps 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 beautiful people,” Cannon says. He says the stigma some people feel because of HIV can prevent them from going to gyms or going out and being active. A lack of social support can also hold them back.


If you don’t feel comfortable in public facilities, ask a friend or family member to train with you. It provides support and makes you accountable to someone else for getting in shape.

Money is often another concern. “Thirty to 35% of people living with HIV live at or just above the federal poverty line,” says Hardy.

But fitness costs nothing. And that doesn’t require a gym.

A strong exercise program consists of only three parts:

“Start with 1 to 2 days a week, 20 to 30 minutes at first, then gradually build up to 3 to 4 days a week,” suggests Cannon. “This will minimize the pain you feel after exercise or activity that you are not used to.”

Force versus muscle

Before effective therapy for HIV wasting syndrome was a challenge. The disease uses your muscle tissue for energy.


“Untreated HIV infection is a very active process and burns calories,” says Hardy. “The body was burning muscle tissue, and people was wasting it and looking very sick.” Today, anti-HIV drugs are preventing this from happening.

Yet muscle loss and muscle building can be more of a challenge for people living with HIV than for others. A small study has shown that older people living with HIV lose muscle at the same rate as anyone their age. But, when they tried to build muscle through an exercise program, they didn’t do it as much as HIV-negative people.

But don’t be discouraged. The benefits of exercise are beyond what you can see.

“Muscle mass and strength are not the same thing,” Cannon says. “We place a lot of importance on what we can see in the mirror, but at the cellular level, there’s a lot going on.”

If you are just starting out, Cannon suggests a series of strength training exercises.

“In order for muscle to grow, you have to put some kind of stress or resistance on it,” he says. “A set of strength training exercises, such as machines, free weights, resistance bands or weight training exercises, will build strength. It will take 8 to 12 weeks for your body to adjust. Don’t be in a rush to move on to three sets. A set will build strength and endurance. You can get stronger but still not look like a bodybuilder. “

Build muscle with supplements

Supplements such as animal or vegetable protein powder, creatine, and beta-hydroxymethylbutyrate (HMB) can help you build and maintain muscle. Most do not interact with anti-HIV drugs, with one exception.

“One class of anti-HIV drugs that we rely on very heavily now are integrase inhibitors,” says Hardy. “If a supplement contains calcium, magnesium, iron or aluminum, it may lessen the effects of this anti-HIV drug.”

Check with your doctor before taking any supplements. If you want to take a supplement with any of these, your doctor may suggest that you space out 2 to 6 hours before or after taking your medicine. This way the two are not in your stomach at the same time.

What about opportunistic infections?

You can gain weight in the gym, but you won’t get an opportunistic infection (OI). This is because OIs come from inside you, not sweaty surfaces.

“OIs come from bacterial, fungal, or parasitic infections that our bodies already carry,” says Hardy.


In people with healthy immune systems, the body keeps these infections at bay and they never turn into disease. But in people who have untreated HIV or whose medicines don’t work, these infections can progress and make you sick.

OIs are less common today thanks to effective treatment for HIV. The gym will not change your risk for these infections. The best way to prevent them is to take your anti-HIV medicines.

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