How Progressive Resistance Exercise Benefits Adults Living with HIV/AIDS
Thanks to tremendous medical advancements, HIV has largely transformed from a fatal diagnosis to a manageable chronic condition. With longer life expectancy, however, comes a new set of health challenges.
People living with HIV now often face the cumulative effects of aging alongside HIV-related health concerns, including increased risk of heart disease, type 2 diabetes, changes in body composition, and physical disability 1 2 3 . In this new landscape, effective self-management strategies have become crucial for maintaining quality of life.
Systematically increasing resistance as strength improves
Addressing long-term health challenges of living with HIV
Supported by clinical research and systematic reviews
Progressive resistive exercise (PRE), also known as progressive resistance training, is a structured approach to strength building where participants exercise their muscles against a resistance that is systematically increased as their strength improves 4 .
Muscle weakness and wasting were historically common and devastating complications of HIV before the advent of effective antiretroviral therapy. While modern treatments have dramatically reduced severe wasting, many people living with HIV still experience gradual muscle loss and functional decline due to both the virus and the aging process 3 .
The safety and benefits of PRE for adults living with HIV have been confirmed through multiple systematic reviews and meta-analyses that pool data from numerous clinical trials.
| Benefit Category | Improvements |
|---|---|
| Body Composition | Increased body weight, lean body mass 1 3 |
| Physical Strength | Improved upper and lower body strength 3 |
| Cardiorespiratory Fitness | Increased maximum oxygen consumption 3 |
| Psychological Well-being | Improved health-related quality of life 3 |
| Functional Capacity | Better performance on functional tests 4 |
Interactive chart showing improvements in strength, body composition, and quality of life would appear here.
The High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults With HIV (HEALTH) represents a cutting-edge approach to exercise intervention 2 .
The HEALTH study is a randomized trial conducted at two sites involving 100 older adults with HIV (age 50+) who report fatigue and lead sedentary lifestyles.
Participants are randomized to one of two exercise regimens:
Participants receive either a biobehavioral coaching and mobile health (mHealth) text messaging intervention or a control condition to support long-term exercise adherence 2 .
The HEALTH study is examining a comprehensive set of outcomes to determine which exercise approach is more beneficial:
Short Physical Performance Battery (SPPB) and 400-meter walk test
Assessed using the HIV-Related Fatigue Scale
Evaluated through muscle biopsies and blood tests
Measured via dual-energy X-ray absorptiometry (DXA) scans
| Parameter | High-Intensity Interval Training (HIIT) Group | Continuous Moderate Exercise (CME) Group |
|---|---|---|
| Intensity | 80-95% of maximal heart rate during high-intensity intervals | Moderate, steady intensity |
| Pattern | Repeated alternating short bouts of high and low intensity | Continuous moderate intensity |
| Session Duration | Matched to expend similar total energy as CME group | Standard duration |
| Supervision | Fully supervised | Fully supervised |
| Frequency | 3 times per week | 3 times per week |
The compelling evidence for PRE raises an important question: how can people living with HIV safely incorporate these exercises into their lives?
Research shows that benefits depend on consistent participation over time. Unfortunately, studies indicate that less than 50% of participants continue to exercise regularly once supervised programs end 2 .
This highlights the importance of finding enjoyable activities and building sustainable habits.
Visualization showing exercise adherence rates during supervised programs vs. maintenance phases would appear here.
The scientific evidence makes a compelling case: progressive resistive exercise is far more than a fitness trend for adults living with HIV.
When implemented appropriately and consistently, PRE offers a safe, effective strategy for protecting physical function, managing symptoms, and promoting overall well-being for people aging with HIV.
Perhaps the most profound benefit of PRE lies in its ability to empower individuals in their healthcare journey. In a life often filled with medical appointments and medication schedules, the strength built through PRE represents something powerful—an active, personal contribution to one's health that extends beyond the pharmacy.
As research continues to refine our understanding of optimal exercise formats and support strategies, the fundamental message remains clear: building physical strength through progressive resistance exercise can help build the resilience needed to not just live with HIV, but to thrive despite it.
PRE is a safe, evidence-based intervention that helps adults with HIV maintain physical function, improve quality of life, and build resilience.