Effects of aerobic exercise on health outcomes and quality of health in people living with HIV on antiretroviral therapy
Keywords:
Aerobic exercise, HIV, quality of life, UgandaAbstract
HIV remains a global major public health issue and the cases in developing countries are so high. Antiretroviral Therapy (ART) plays a big role in reducing the morbidity and mortality among the people living with HIV (PLHIV). The ART is associated with long-term side effects including an increased risk of Non-Communicable Diseases (NCDs) such as cardiovascular disease, diabetes, and metabolic syndrome. These complications negatively impact the quality of life of PLHIV, necessitating holistic approaches to care. While ART controls viral replication, complementary strategies, including lifestyle interventions like exercise, are essential to mitigate NCDs. Exercise, particularly aerobic and resistance training, has been shown to improve cardiovascular health, metabolic function, and psychological well-being in PLHIV. Specific exercises such as walking, jogging, cycling, swimming, and weight training can help manage NCDs effectively when tailored to an individual’s fitness level and health needs. Supervised exercise programs, led by professionals such as clinical exercise physiologists, are critical to ensure safety, optimize benefits, and encourage adherence. These programs could be integrated into HIV care to provide structured and effective interventions. In limited resource countries, access to exercise facilities, and a lack of trained professionals present significant barriers to implementing exercise programs for PLHIV. Additionally, cultural misconceptions and a lack of awareness about the role of exercise in health management hinder uptake. However, from the reviewed papers, research gaps exist regarding context-specific exercise protocols, the long-term benefits of supervised exercise, and how to best implement these programs in resource-limited settings. In conclusion, structured exercise programs hold great potential to improve health outcomes and quality of life for PLHIV on ART. Addressing existing barriers and conducting further research are essential to maximize the impact of exercise as a tool for managing NCDs in this population.
Downloads
References
Althoff, K. N., Smit, M., Reiss, P., & Justice, A. C. (2016). HIV and ageing: improving quantity and quality of life. Current Opinion in HIV and AIDS, 11(5), 527.
American College of Sports Medicine. (2018). ACSM's guidelines for exercise testing and prescription (10th ed.). Wolters Kluwer.
American College of Sports Medicine. (2021). ACSM's guidelines for exercise testing and prescription (11th ed.). Wolters Kluwer.
Argent, R., Daly, A., & Caulfield, B. (2018). Patient Involvement With Home-Based Exercise Programs: Can Connected Health Interventions Influence Adherence? JMIR mHealth and uHealth, 6(3), e47.
Bannell, D. J., France-Ratcliffe, M., Buckley, B. J. R., Crozier, A., Davies, A. P., Hesketh, K. L., Jones, H., Cocks, M., Sprung, V. S., & MOTIVATE Team (2023). Adherence to unsupervised exercise in sedentary individuals: A randomised feasibility trial of two mobile health interventions. Digital Health, 9, 20552076231183552.
Biddle, S. J. H., Faint, N., & Sharp, S. R. (2019). Effects of structured and supervised physical exercise on physical, mental, and immune systems in people living with HIV/AIDS. Journal of Exercise Science & Fitness, 17(3), 203-210.
Bopp, C., Phillips, K. D., Fulk, L. J., & Hand, G. A. (2003). Clinical implications of therapeutic exercise in HIV/AIDS. Journal of the Association of Nurses in AIDS Care, 73.
Campbell, J. P., & Turner, J. E. (2018). Debunking the Myth of Exercise-Induced Immune Suppression: Redefining the Impact of Exercise on Immunological Health Across the Lifespan. Front Immunol, 9, 648.
CDC. (2020). Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/hiv/basics/whatishiv.html.
CDC. (2020). Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/hiv/basics/whatishiv.html
Centre for Health Protection. (2021). Doctor's handbook: The physiologic reactions to exercise training are significantly influenced by the amount and intensity of exercise. Department of Health, Hong Kong Special Administrative Region. Retrieved from https://www.chp.gov.hk/archive/epp/files/DoctorsHanbook
Chang, J-H., Yang, P-C., & Tu, H. (2014). Pattern analysis in daily physical activity data for personal health management. Pervasive Mob Comput, 13, 13-25.
Chertoff, J. (2020). Aerobic exercise examples. Retrieved from https://www.healthline.com/health/fitness-exercise/aerobic-exercise-examples#athome-exercises
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., ... & Tate, D. F. (2016). Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065.
Collado-Mateo, D., Lavín-Pérez, A. M., Peñacoba, C., Del Coso, J., Leyton-Román, M., Luque-Casado, A., Gasque, P., Fernández-del-Olmo, M. Á., & Amado-Alonso, D. (2021). Key factors associated with adherence to physical exercise in patients with chronic diseases and older adults: an umbrella review. Int J Environ Res Public Health, 18(4), 2023.
Galaviz, K. I., Narayan, K. M. V., Lobelo, F., & Weber, M. B. (2015). Lifestyle and the Prevention of Type 2 Diabetes: A Status Report. Am J Lifestyle Med, 12(1), 4–20.
Grace, J. M. (2016). Exercise therapy for Acquired Immune Deficiency Syndrome (AIDS) patients. InTech. doi: 10.5772/64651
Hong, C., Queiroz, A., & Hoskin, J. (2023). The impact of the COVID‐19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review. Journal of the International AIDS Society, 26(3), e26060.
Hossain, M. N., Lee, J., Choi, H., Kwak, Y. S., & Kim, J. (2024). The impact of exercise on depression: how moving makes your brain and body feel better. Physical activity and nutrition, 28(2), 43–51.
Ibeneme, S. C., Omeje, C., Myezwa, H., Ezeofor, S. N., Anieto, E. M., Irem, F., ... & Ibeneme, G. C. (2019). Effects of physical exercises on inflammatory biomarkers and cardiopulmonary function in patients living with HIV: a systematic review with meta-analysis. BMC Infectious Diseases, 19, 1-22.
Ibeneme, S. C., Uwakwe, V. C., Myezwa, H., Irem, F. O., Ezenwankwo, F. E., Ajidahun, T. A., ... & Fortwengel, G. (2022). Impact of exercise training on symptoms of depression, physical activity level and social participation in people living with HIV/AIDS: a systematic review and meta-analysis. BMC Infectious Diseases, 22(1), 1-25.
Jaggers, J. R., & Hand, G. A. (2014). Health Benefits of Exercise for People Living With HIV: A Review of the Literature. Am J Lifestyle Med, 10(3), 184–192.
Jones, H., George, K. P., Scott, A., Buckley, J. P., Watson, P. M., Oxborough, D. L., Thijssen, D. H., Graves, L. E. F., Whyte, G. P., McGregor, G., Naylor, L. H., Rosenberg, M., Askew, C. D., & Green, D. J. (2021). Charter to establish clinical exercise physiology as a recognised allied health profession in the UK: a call to action. BMJ Open Sport Exerc Med, 7(3), e001158.
Krupa S., Amina AP., William JH. And Amneris EL., (2012) The Physiological Effects of Obesity in HIV-Infected Patients
Larson, A. (2021). Maintaining physical activity to prevent pharmacological side effects and enhance quality of life. Journal of Health and Wellness, 24(2), 112-119.
Maduagwu, S. M., Gashau, W., Balami, A., Kaidal, A., Danue, B. A., ifenyi Umeonwuka, C., & Akanbi, O. A. (2017). Aerobic exercise improves quality of life and CD4 cell counts in HIV seropositives in Nigeria. Journal of Human Virology & Retrovirology, 5(3).
Martin, S. A., Pence, B. D., & Woods, J. A. (2009). Exercise and respiratory tract viral infections. Exercise and Sport Sciences Reviews, 37(4), 157–164.
McIntyre, K. M., Puterman, E., Scodes, J. M., Choo, T. H., Choi, C. J., Pavlicova, M., & Sloan, R. P. (2020). The effects of aerobic training on subclinical negative affect: A randomized controlled trial. Health Psychology, 39(4), 255.
Ministry of Health Uganda. (2016). Consolidated Guidelines for the Prevention and Treatment of HIV and AIDS in Uganda.
Ministry of Health Uganda. (2018). Consolidated Guidelines for the Prevention and Treatment of HIV and AIDS in Uganda.
Moreland, S., Namisango, E., Paxton, A., & Powell, R. A. (2013). The costs of HIV treatment, care, and support services in Uganda. Measure Evaluation Technical Report. Retrieved from https://www.measureevalua tion.org/resources/publications.html
Moyo-Chilufya, M., Maluleke, K., Kgarosi, K., Muyoyeta, M., Hongoro, C., & Musekiwa, A. (2023). The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis. EClinicalMedicine, 65, 102255.
Naylor, P. J., Sloane, L., & David, D. (2019). Promoting exercise adherence in individuals living with HIV: A review of strategies. Journal of HIV/AIDS & Social Services, 18(4), 345-360.
Nicholas, M., Nsibambi, C A. N., Ojuka, E., & Maghanga, M. (2024a). The impact of 12-week supervised aerobic exercise on psychological markers in HIV clients on ART. Adv Health Exerc, 4(2), 154-161.
Nicholas, M., Nsibambi, C. A. N., Ojuka, E., & Maghanga, M. (2024b). Aerobic-exercise training effects on immunological markers in individuals on highly active antiretroviral therapy in Uganda. Turk J Kinesiol, 10(2), 101-109.
Nicholas, M., Nsibambi, C.A.N., Ojuka, E. & Maghanga. M., (2024c). Twelve weeks aerobic exercise improves anxiety and depression in HIV positive clients on art in Uganda. International Journal of Sport Exercise and Training Sciences, 10(4), 288-298.
Nicolson, P. J., Bennell, K. L., Dobson, F. L., Van Ginckel, A., Holden, M. A., & Hinman, R. S. (2017). Interventions to increase adherence to therapeutic exercise in older adults with low back pain and/or hip/knee osteoarthritis: a systematic review and meta-analysis. Br J Sports Med, 51(10), 791-799.
Nystoriak, M. A., & Bhatnagar, A. (2018). Cardiovascular effects and benefits of exercise. Frontiers in Cardiovascular Medicine, 5, 135.
O’Brien, K. K., Tynan, A. M., Nixon, S. A., & Glazier, R. H. (2016). Effectiveness of aerobic exercise for adults living with HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infectious Diseases, 16(1), 1-56.
O'Brien, K. K., Tynan, A. M., Nixon, S. A., & Glazier, R. H. (2016). Effectiveness of aerobic exercise for adults living with HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infectious Diseases, 16, 182.
Odunitan-Wayas, F. A. (2018). Evidence profile: Benefits of physical activity for people living with HIV and AIDS for selected health outcomes. Retrieved from www.who.int/docs/default-source/physical-activity/call-for-consultation/evidence-on-pa-and-hiv2.pdf?sfvrsn=5a576e1f_4
Oguntibeju O. O. (2012). Quality of life of people living with HIV and AIDS and antiretroviral therapy. HIV/AIDS (Auckland, N.Z.), 4, 117–124.
Okoroiwu, H. U., Umoh, E. A., Asanga, E. E., Edet, U. O., Atim-Ebim, M. R., Tangban, E. A., ... & Povedano-Montero, F. J. (2022). Thirty-five years (1986–2021) of HIV/AIDS in Nigeria: bibliometric and scoping analysis. AIDS Research and Therapy, 19(1), 1-15.
Pearce, A., & Longhurst, G. (2021). The Role of the Clinical Exercise Physiologist in Reducing the Burden of Chronic Disease in New Zealand. Int J Environ Res Public Health, 18(3), 859.
Pedro, F. C., Oliveira, M. M. D., Andrade, R. S., Costa, A. C. T. R. B., Pereira, C. R., Oliveira, P. F. R. E., ... & Pereira, L. J. (2024). Resistance Training Improves the Immune Response, Mainly Associated with CD8+ T Lymphocytes and B Lymphocytes, in Mice. Brazilian Archives of Biology and Technology, 67, e24220284.
Quigley, M., Smith, R., & Johnson, L. (2019). Exercise as a technique to address disability and enhance the health of individuals living with HIV. Journal of Rehabilitation Research and Practice, 35(2), 123-135.
Soan, E. J., Street, S. J., Brownie, S. M., & Hills, A. P. (2014). Exercise physiologists: essential players in interdisciplinary teams for noncommunicable chronic disease management. J Multidiscip Healthc, 65-68.
Talwani, R., Gilliam, B., & Howell, C. (2011). Infectious diseases and the liver. Clin Liver Dis, 15(1), 111-130.
Treston, C. (2019). Quality care for people aging with HIV through nurse-led care coordination. Journal of the Association of Nurses in AIDS Care, 30(1), 129-130.
Truong, M. (2021). Depression and anxiety as barriers to ART initiation, retention in care and treatment outcomes
Trusts, P. C. (2020). Opioid use disorder treatment in jails and prisons: Medication provided to incarcerated populations saves lives. Pew Charitable Trusts.
Uganda AIDS Commission. (2011). National HIV Prevention Strategy 2011–2015: Expanding and Doing HIV Prevention Better. AIDS Commission, Kampala, Uganda.
UNAIDS (2017). Global HIV & AIDS statistics — 2022 fact sheet.
UNAIDS (2021). Global HIV & AIDS statistics — 2021 fact sheet.
UNAIDS (2022). Global HIV & AIDS statistics — 2022 fact sheet.
UNAIDS. (2020). Global HIV & AIDS statistics — 2020 fact sheet. Retrieved from https://www.unaids.org/en/resources/fact-sheet
Vaillant, A. A. J., & Naik, R. (2023). HIV-1–associated opportunistic infections. In StatPearls [Internet]. StatPearls Publishing.
Velavan, T. P., Meyer, C. G., Esen, M., Kremsner, P. G., & Ntoumi, F. (2021). COVID-19 and syndemic challenges in ‘Battling the Big Three’: HIV, TB and malaria. International Journal of Infectious Diseases, 106, 29-32.
Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: the evidence. CMAJ, 174(6), 801-809.
Williams, S. L., & French, D. P. (2019). The effectiveness of interventions to promote physical activity in people with chronic conditions: A systematic review. Health Psychol Rev, 13(1), 21-42.
Zou, Y., Liu, S., Guo, S., Zhao, Q., & Cai, Y. (2023). Peer Support and Exercise Adherence in Adolescents: The Chain-Mediated Effects of Self-Efficacy and Self-Regulation. Children (Basel, Switzerland), 10(2), 401.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mwebaze Nicholas, Chebet Milton , Linika Lumbuye , Nabaggala Elyvania , Nahwera Loyce
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This work is licensed under a 