Exercise is activity that you do on a regular basis (every day, or several times a week) for the purpose of improving your health. Keep in mind that if it’s something you do every day as part of your job, it’s probably not exercise. Exercise needs to be outside of your daily routine.

That doesn’t mean that increasing your normal activities during the day can’t be helpful. Some studies have shown that adding small amounts of activity throughout the day can improve your health. This might mean taking the stairs instead of the elevator, parking farther back in the parking lot, or walking to places less than a mile or two away.

Everyone knows that exercise can make you stronger, give you endurance, and strengthen your heart. But there are many benefits of exercise that are especially helpful for people living with HIV (HIV+). An exercise routine can:

• Increase muscle mass
• Reduce fat around the waist (lipohypertrophy)
• Lower total cholesterol and LDL (the bad cholesterol)
• Raise HDL (the good cholesterol)
• Lower triglycerides
• Help control blood sugars
• Strengthen bones (help prevent bone disease)
• Strengthen your immune system
• Reduce stress
• Give you more energy throughout the day

There is also a strong connection between muscle mass and immunity. By increasing the size of your muscles, you may be able to slow the progression of your HIV. People who exercise often have higher CD4 cell counts and fewer side effects from HIV and HIV drugs.

There are several different types of exercise, all of which are important to try to include in an exercise routine. Some types of exercise to consider are:

Aerobic exercise uses oxygen to burn fat in your body. This is why people who are trying to lose weight often do a lot of aerobic exercise. It is also called cardiovascular exercise, because it raises your heart rate and makes your heart stronger. Besides burning fat, it can increase your endurance, meaning that you don’t get tired as quickly when you use energy.

Aerobic exercises can also lower cholesterol and triglycerides, or lower blood sugars. (In some HIV+ people, exercise may not lower cholesterol and triglycerides enough. If this is the case, speak to your health care provider about lipid-lowering drugs.)

Some HIV+ people should not do aerobic exercise, such as those who are wasting or have very little body fat. Ask your health care provider if you have any conditions that might keep you from doing aerobic exercise.

Good aerobic exercises:

• Fast walking
• Jogging
• Stair-climbing
• Bicycling
• Swimming

Weight-bearing exercise (also called resistance or strength training) is when you move weight with your muscles. When you do this, your muscles tear, but when they heal they are bigger and stronger. It is important that when you do weight-bearing exercise, you wait until that part of the body is not sore anymore before you exercise it again. Your body needs plenty of time to heal the muscles.

Weight-bearing exercise can be helpful for most HIV+ people and can help prevent or fight wasting. If you have had muscle loss, weight-bearing exercise is probably good for you. However, if you have osteoporosis ( bone disease) or if you have been hurt recently, weight-bearing exercise could be dangerous, and you may need a physical therapist. Ask your health care provider if weight-bearing exercise is okay for you.

Good weight-bearing exercises:

• Lifting weights with machines
• Push-ups
• Pull-ups
• Squats or lunges
• Dumbbells

Mind-body exercise such as yoga can improve physical qualities such as strength, flexibility, balance, and endurance. It can also improve mental health and help with anxiety and depression (which is very common in HIV+ women). As with all new exercise routines, it is important to start slowly with yoga and take beginner classes. Many community centers (ie, YMCA) offer low-cost or free yoga classes.

Good mind-body exercise:

• Yoga
• Martial arts
• T’ai Chi
• Meditation

• Speak to your health care provider about what types of exercise are okay for you
• Record your weight and the measurements of your arms, legs, chest, stomach, and hips before starting your exercise program. If possible, also check your body composition with a Bio-electrical Impedance Analysis (BIA). A BIA can be done by your health care provider or by a fitness trainer at the gym.
• Set realistic goals for yourself, such as increasing or decreasing some of your body measurements
• Find an exercise buddy. Setting up an exercise routine with a friend can keep you motivated and less likely to skip workouts!
• Start slowly. Do what you can, but don’t overdo it. Be patient with your body and your workout.
  • When starting aerobic exercise, walk or jog at a pace where you can talk but are not out of breath. Try to work up to 30 minutes three times a week. You may start out walking/jogging for 10 minutes and slowly add 5 minutes to your work out until you are up to 30 minutes or more at least three times a week.
  • When starting weight-bearing exercise, use slow, controlled movements. Dropping the weights quickly can be dangerous and will not help build muscle. Try to work up to weight-bearing exercise at least three times a week for 30 minutes or more.
• Stay hydrated! Remember to drink a lot of water before, during, and after your workout.
• Eat well! Good nutrition is important to staying healthy and can help you exercise better. Wait 2 hours after a full meal before exercising.
• Don’t exercise when you're feeling sick (feverish, vomiting, dizzy, diarrhea, etc.)

Starting an exercise routine requires commitment. It may take a while for you to get used to your routine, but don’t give up! If you are able, try hiring or talking to a certified fitness trainer to help you develop a good routine. Keep your health care provider informed about all forms of exercise you are doing.