December 1st was World AIDS Day, thus I thought it appropriate to provide some insight into the role of exercise in managing HIV/AIDS.
Human immunodeficiency virus (HIV) is a virus that attacks certain cells in the immune system, resulting in a decrease in immune function. An HIV positive individual is thus at an increased risk for infectious diseases. HIV is progressive and is classified into 3 stages, the final stage being acquired immune deficiency syndrome (AIDS).
There is currently no vaccine or cure for HIV. Therefore, management of the condition is crucial to maintain a good quality of life for as long as possible. According to ACSM, exercise has been scientifically proven to be effective in the management of HIV, especially in the early stages when an individual is still asymptomatic and healthy.
Common symptoms of HIV include fatigue, diarrhoea and weight loss. These symptoms must be carefully considered when designing an exercise programme so that the symptoms are not exacerbated by exercise. The main goal of the exercise programme is to keep the individual as physically healthy as possible. An HIV positive individual will reap the same benefits in terms of cardiovascular fitness, muscular strength and flexibility as any other person engaging in a regular exercise programme. However, special considerations need to be taken with regards to intensity and duration of exercise.
Immune function drops immediately after high intensity exercise or exercise that is performed for a long duration (more than 90 minutes). Because these individuals already have a low immune function, it is important not to compound this. Therefore, ACSM recommends that exercise be kept to a shorter duration – no more than 60 minutes per session, 3 to 5 days per week. Intensity should also be moderate, ranging between 60 and 75% of the maximum heart rate.
ACSM also recommends that aerobic exercise using the major muscle groups is performed as part of any exercise regimen. Therefore, exercises such as walking, swimming and cycling should be included. This will enable the HIV positive person to maintain a high level of cardiovascular fitness, which is important in reducing the risk for cardiovascular disease. Due to the increased weight loss associated with HIV, it is important that these individuals also perform resistance exercise on a regular basis to maintain high levels of muscle mass. Stretching should be part of the exercise regimen to maintain flexibility and joint range of motion. Functional exercises should also be included in the exercise programme to maintain functional ability.
Other special precautions that should be taken include exercising in an appropriate temperature to avoid getting sick and exercising away from others to avoid picking up their infections. The general health of the individual, including blood pressure and heart rate, should be assessed before each session. If the individual is not feeling well, then exercise should be postponed, so that the individual’s immune system can fight off any potential infection.
HIV is often seen as a death sentence from the minute of diagnosis; however, an individual can live a healthy, asymptomatic life for many years. It is, therefore, important to maintain good health and physical function, thereby improving quality of life.