Exercise is Key for People with HIV

Exercise is good for you. Shocking, right? Hitting the gym lowers your risk of heart disease, increases strength, and it doesn't take a scientific study for any sentient adult human being to figure out that it's good for the libido; that is, it will markedly improve your sex life.

It's not only gay men who have become more likely to lift weights and jump on the treadmill. Since the beginning of the epidemic, people living with HIV have intuitively known this.

All of the principles that dictate exercise routines for the average person translate especially well for those with HIV. Because of the effects of the disease, and the side effects of HIV medication, the importance of exercise has some added elements. If there's no empirical evidence that conclusively proves that exercise actually helps fight the disease, it has been demonstrated that it can reduce the side effects and, yes, increase quality of life (sex life included).

One of the most powerful effects of HIV is what it does to brain functions like memory, attention, problem solving and other basic cognitive thinking. The more rare, severe negative effects, such as dementia, can be limited by some medications, but more subtle effects on brain function can go untreated.

In a study earlier this year conducted by the University of California, San Diego, exercise was found to minimize lesser forms of neurocognitive impairment. "HIV-infected adults who exercise are approximately half as likely to show NCI as compared to those who do not," the study concluded.

Another obvious benefit is combating weight redistribution. Many taking medication for HIV complain that their arms get smaller and their waist gets bigger - the dreaded "crix hump" and lipdistrophy. A good diet certainly helps. But it won't do it alone.

You need to find a balance between weight lifting and cardiovascular exercise, which will be even more beneficial. And you'll find that, once you start becoming a gym rat, your diet will naturally improve; no one who exercises wants to undo all that hard work with fistfuls of hard candy.

The key is the balance between anabolic (weight gain from weight lifting) and anaerobic (weight loss from increasing the heart rate with sustained aerobics in any form). An over-reliance on burning the fat will leave you looking too gaunt and is at least as unhealthy as being overweight. Ignoring cardio and just hitting the weights won't do much to burn belly fat or help your heart. This holds true for anyone, but even more so for the HIV-positive persons.

Poz exercisers will see a marked decrease in LDL (the bad cholesterol) to increase in bone density. But here's the key - and if this doesn't persuade to exercise, nothing will: The Department of Health in Columbia, S.C., has shown that, yes, exercise will slow the progression of HIV and help prevent the onslaught of full-blown AIDS.

Then there's stress, something that everyone in modern society has plenty of, but people with HIV even more than a Wall Street trader. Sure enough, exercise helps lower stress levels.

Regular exercise improves your overall sense of well-being, increases endorphin production (the chemical in your body that makes you feel good), and temporarily focuses your mind on a physical activity instead of what's stressing you out, according to a study done by the Mayo Clinic. Considering the devastating psychological impact of an HIV diagnosis, this may be the most important benefit of all.

Anyone who hasn't made regular exercise part of their regime finds it hard to get to the gym (which is why gyms are so crowded in January, until the people who make New Year's resolutions eventually drop out). Paradoxically, HIV's side effects, such as fatigue, digestive problems and depression, make it all the harder to get off the couch, throw on a pair of sneakers, shorts and tank top, and get going. Keep in mind that when it comes to working out, 90 percent of the effort is getting to the gym.

Pozzers need to focus on what they can do, instead of what they can't do, Los Angeles trainer Sam Page told EDGE. Opting out of all exercise shouldn't be an option. "If someone is really ill and doesn't have the energy to do cardio," he added, "we do small amounts of that and focus on resistance training, and use that to build endurance."

Even if a client only stretches, that results in increased flexibility. The benefits of any kind of physical routine are huge, Page noted. Page has even developed an HIV-positive-specific workout routine, available online.

Just as in the general population, folks living with HIV each have different needs and complications. Page points out that neuropathic conditions, for example, "can be addressed through exercise, and I address them with a lot of success.

"You have to take into consideration each person's situation."

Now that I've outlined the good stuff, yes, there are a few caveats.

While regular, even daily, exercise is great, overtraining is not so great, and is even counterproductive. Limited studies have suggested that sporadic, exhaustive exercise routines may increase the strain on your immune system. Regular, moderate exercise is far more beneficial to your health without the added stress.

"I tell people to listen to their body," Page said. "If they're feeling fatigued, or they're not sleeping well, they may be overtraining. Everyone needs to take a day off. No one should be working out seven days a week, but that's especially true for the HIV population."

Any exercise increases risk of injury, but for pozzers, injuries can take longer to heal, TheBody.com has reported. As with any exercise, it's important to walk before you run. Don't harness your new-found motivation and go on a 10-mile run or try to bench press like the gorilla next to you. Like the muscles you're trying to strengthen, start small and build in intensity and strength level.

As always, it's important to check with the doctor before changing your routine too much, just to make sure you're not putting yourself at a higher risk. Positively Aware recommends. Testing all of your vitals - blood pressure, heart rate, blood sugars, etc. - before starting a new exercise routine, and checking their levels regularly.

That said, if your doctor forbids you from getting any exercise at all, you might want to get a second opinion. I'm not going to second guess your primary physician. But you can.

Cyd Zeigler is the co-founder of Outsports, the pioneering LGBT sports website and the LGBT Sports Coalition. Media where he has been a vocal advocate for out-athletes include Playboy, CNN, MSNBC and SB Nation.

This story is part of our special report: "Keeping Fit with HIV". Want to read more? Here's the full list.