Many years ago, HIV was a death sentence. Keeping healthy by exercising couldn’t even be considered. 

 HIV now in 2024 can be viewed as a lifestyle condition, similar to diabetes where the lifespan of those diagnosed is similar to that of the general population. The medications used now, although not a cure have allowed for this.

Diagnosed folks can now implement a consistent exercise routine as part of an optimal health plan.

  We are familiar with some of the benefits of regular exercise. These benefits hold true for those with HIV as well. Some of these are stimulating the immune system, elevating mood, enhancing mobility and strength, cardiovascular fitness, and it can also make your microbiome, or the useful bacteria  in the gut, healthier. 

Those  who are HIV-positive are more prone  to have diabetic conditions, cardiovascular disease, and as a side effect of meds, weight gain. This makes regular exercise even more important. Some points that focus on how essential a consistent program can be, are as follows.

Exercise for those with HIV can:

  • Boost the mood
  • Help focusing
  • Lower distress
  • Give better sleep
  • Manage weight
  • Protect against diabetes and cardiovascular issues.
  • Lower the risk for certain cancers
  • Increase muscle mass.

There is also a connection between muscle mass and immune function. People who exercise often have higher CD4 counts and fewer side effects from HIV and HIV drugs.

Psychological Barriers:

Regardless of the benefits of exercise, a large number of individuals who have HIV just push it aside.

The stigma and a sense of worthlessness cause some people who have HIV to eschew exercise and this facilitates a mental block, stopping them from getting out and becoming active. A lack of social support may also hold them back.   

One can exercise with friends and family members. This provides support and helps to make one accountable to someone else for getting fit.

Putting the body under some stress and using resistance machines, free weights, resistance bands, or body weight exercises, will build strength. It’s going to take about three months for the body to adapt. Perseverance is the key. Progress will come.

Finances may be another concern. Many may not be able to afford a gym subscription. But fitness doesn’t have to cost a thing. One does not need a gym.

A powerful exercise program is simple:

  • Stretches to keep you flexible
  • Strength exercises with free weights, or calisthenics
  • Aerobic training like walking or cycling for cardiovascular health.

Start slowly with one or two days, 20 to 30 minutes at a time per week and work up to a healthy 3 or 4 day habit. 

Before the present HIV therapy, wasting syndrome was a horror. The illness ate the muscle tissue as a source of energy. Presently, muscle loss and building muscle may be bigger challenges for people with HIV than for others. One 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. Aging may play a part in the difficulty to put on the muscle mass usually seen in younger individuals. But the benefits of exercise go beyond what you can see. Concentrate on strength and consistency. 


Supplements like whey, extracts and plant protein powders, may help to build and maintain muscle. Most have no interactions with HIV medication, with a single exception so far: Integrase Inhibitors.

  If the supplement contains calcium, magnesium, iron, or aluminum, it can lessen the effects of this HIV medication.

Drug interactions: There is a caution for interactions with some supplements (containing calcium, magnesium or aluminum), antacids and multivitamins. This also includes antacids that include magnesium or aluminum.
This requires separating the dolutegravir dose. These products need to be taken a minimum of two hours after dolutegravir or six hours before. Another important interaction is that dolutegravir doubles levels of metformin (A diabetic drug) , and requires careful monitoring.

This is only for supplements – it is NOT a concern for foods like milk and cheese that contain calcium.

It is advisable to check with one’s doctor before  taking any supplements. If one wants to take a supplement with any of these elements, one’s doctor may suggest that it is spaced  out 2 to 6 hours before or after taking the medication. 

Opportunistic Infections.

 One is not going to pick up an opportunistic infection at the gym. That’s because opportunistic infections come from inside the body and not from outer surfaces.

They come from the bacterial, fungal, or parasitic infections the body is already carrying.

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 fail , these infections can progress and make one ill.

Opportunistic infections are not as common today thanks to effective HIV medications. A gymnasium will not alter one’s risk for these infections. The best way to prevent them is to be consistent with one’s HIV treatment.

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