Evidence-Informed Practical Recommendations for Increasing Physical Activity Among Persons Living With HIV

Jessica L. Montoya; Catherine M. Jankowski; Kelly K. O'Brien; Allison R. Webel; Krisann K. Oursler; Brook L. Henry; David J. Moore; Kristine M. Erlandsong


AIDS. 2019;33(6):931-939. 

In This Article

Intrapersonal Barriers

In a systematic review of 45 studies of physical activity in PLWH,[53] lower engagement in physical activity was consistently associated with demographic (i.e. older age and fewer years of formal education), HIV-specific and biologic (i.e. being on ART, lower CD4+ T-cell counts, lipodystrophy, lower cardiorespiratory fitness and opportunistic infections) and psychological (i.e. lower motivation, depression and worse self-perceived physical function) variables. Moreover, the experience of these physical and mental health challenges that hinder engagement in physical activity may be unpredictable and episodic for PLWH.[54] Many PLWH experience great symptom burden, including neuropathy,[55] fatigue[56] and reduced cardiorespiratory fitness,[57] with even greater impairments among older PLWH.[58] Reduced cardiorespiratory fitness among PLWH as indicated by impaired peripheral oxygen uptake,[49] dysfunction of skeletal muscle mitochondria,[59] reduction in mitochondrial DNA content[60] and/or limitations in lung function[61] (e.g. impaired carbon monoxide diffusion capacity[62]) may interfere with adaptation to physical activity. Aerobic and resistance exercise, however, may reduce symptoms such as HIV-related fatigue.[11,12] Adherence to a moderate-intensity, home-based, aerobic exercise[12] or a supervised aerobic and resistance exercise intervention has shown reduced fatigue among PLWH, with increased benefit among those with high adherence.[11]