Effective Exercise Prescription Framework for Older Adults with HIV

Importance of Exercise for Older Adults Living with HIV

Regular exercise is critical for older adults living with HIV (OPLWH), as it plays a significant role in managing the physical and psychological challenges associated with aging and the disease itself. With advancements in antiretroviral therapy (ART), many individuals living with HIV are experiencing longer lifespans, which brings the necessity for effective management strategies tailored to their unique needs (Chetty et al., 2025).

Research indicates that exercise can mitigate the adverse effects of HIV and its treatment, such as muscle wasting, cardiovascular issues, and mental health disorders (Erlandson et al., 2018). For OPLWH, the ability to engage in physical activity can enhance their quality of life by improving cardiovascular fitness, muscle strength, and mental well-being, while also aiding in the prevention of comorbidities that often accompany aging (Hand et al., 2009).

Furthermore, exercise has been shown to improve immune function, which is particularly beneficial for individuals living with HIV who may have compromised immune systems (Chetty et al., 2021). By fostering both physical and mental resilience, structured exercise programs can significantly impact the overall well-being of OPLWH.

Key Components of a Structured Exercise Prescription

The development of a structured exercise prescription for OPLWH involves several key components, which are essential for ensuring both safety and efficacy (Chetty et al., 2025). These components include:

1. Assessment and Screening: Before initiating any exercise program, a thorough health screening is necessary to identify any contraindications or existing comorbidities. This may include physical activity readiness questionnaires and assessments of cardiovascular health.

2. Goal Setting: Establishing realistic and achievable goals is vital for maintaining motivation and adherence. Goals should be tailored to the individual’s current fitness level, health status, and personal preferences.

3. Type of Exercise: A combination of aerobic, resistance, and flexibility exercises is recommended to address the multifaceted health needs of OPLWH. Aerobic exercises, such as walking or cycling, improve cardiovascular health; resistance training enhances muscle strength; and flexibility exercises promote overall mobility.

4. Frequency and Duration: The general recommendation for older adults is to engage in at least 150 minutes of moderate-intensity aerobic activity per week, along with muscle-strengthening activities on two or more days per week (American College of Sports Medicine, 2016).

5. Progression: Gradual progression in intensity and volume of exercise is crucial. This approach helps to reduce the risk of injury while allowing individuals to adapt to the increasing demands of their exercise regimen.

6. Supervision and Support: Regular supervision by qualified health professionals can enhance adherence and safety. Support from healthcare providers, exercise specialists, and peers can also motivate individuals to remain engaged in their exercise programs.

Benefits of Multidisciplinary Collaboration in Exercise Programs

Multidisciplinary collaboration is fundamental in developing and implementing exercise programs for OPLWH. By drawing on the expertise of various health professionals, including physiotherapists, dietitians, and mental health counselors, a more comprehensive and effective approach to care can be achieved (Chetty et al., 2025).

1. Holistic Care: A multidisciplinary approach allows for the integration of physical, nutritional, and psychological support, addressing the complex needs of OPLWH (Maddocks et al., 2018).

2. Improved Communication: Team collaboration fosters better communication among healthcare providers, leading to more coordinated care plans and enhanced patient education (Reeves et al., 2018).

3. Resource Optimization: Leveraging the strengths of various professionals can optimize resources and provide more comprehensive care, ultimately improving outcomes for patients (Benagiano & Brosens, 2014).

4. Enhanced Adherence: When patients receive consistent messaging and support from a cohesive team, they are more likely to adhere to their exercise prescriptions and overall treatment plans.

Role of Pre-Exercise Health Screening in Exercise Adherence

Pre-exercise health screening is a critical step in ensuring the safety and effectiveness of exercise interventions for OPLWH. It is essential to evaluate individuals’ health status, identify potential risks, and customize exercise prescriptions accordingly (American College of Sports Medicine, 2016).

1. Identifying Risks: Screening helps identify individuals with existing comorbidities, such as cardiovascular disease or musculoskeletal issues, which may require modifications to the exercise program.

2. Safety Assurance: By assessing physical activity readiness, healthcare providers can minimize the risk of exercise-related injuries and complications, promoting a safer environment for physical activity.

3. Motivation and Confidence: An initial health assessment can help build confidence in individuals by providing them with a clear understanding of their capabilities and setting appropriate goals.

4. Monitoring Progress: Regular assessments can be used to evaluate improvements in fitness and health, reinforcing adherence to the exercise regimen and allowing for timely adjustments.

Enhancing Exercise Engagement through Supervision and Support

Supervision and support are crucial for enhancing exercise engagement among OPLWH. The presence of trained professionals can significantly improve adherence and efficacy of exercise programs (O’Brien et al., 2021).

1. Structured Environment: Supervised sessions create a structured environment where individuals feel supported and guided, which can reduce feelings of uncertainty or intimidation often associated with starting a new exercise program.

2. Immediate Feedback: Real-time feedback from trained professionals enables participants to correct their form and technique, enhancing safety and effectiveness.

3. Social Support: Group exercise sessions can foster a sense of community and belonging, which is particularly beneficial for OPLWH who may experience social isolation (Chetty et al., 2021).

4. Motivation and Accountability: Regular supervision provides a level of accountability, encouraging individuals to stick to their exercise plans and maintain motivation through positive reinforcement.

Conclusion

Establishing an effective exercise prescription framework for older adults living with HIV is essential to improve their overall health and quality of life. By focusing on comprehensive assessments, multidisciplinary collaboration, pre-exercise screening, and ongoing supervision, healthcare providers can create tailored exercise programs that meet the unique needs of this population. Such approaches not only enhance adherence and safety but also empower OPLWH to take an active role in their health management.

References

1. Chetty, L., Cobbing, S., & Chetty, V. (2025). Expert Consensus on an Exercise Prescription Framework for Older People Living With HIV in a South African Setting—A Delphi Study. Journal of the Association of Nurses in AIDS Care

2. Erlandson, K. M., et al. (2018). Exercise and HIV: A Review. Journal of Acquired Immune Deficiency Syndromes, 77(3), 307-314

3. Hand, G. A., et al. (2009). Physical Activity and HIV: A Review. HIV/AIDS - Research and Palliative Care, 1, 25-34

4. American College of Sports Medicine. (2016). Exercise and Physical Activity in Older Adults. Medicine & Science in Sports & Exercise, 48(6), 1198-1200

5. Maddocks, M., et al. (2018). Multidisciplinary Team Approach in HIV Management. BMC Infectious Diseases, 18(1), 468

6. Benagiano, G., & Brosens, I. (2014). Teamwork in Health Care: The Benefits of Multidisciplinary Cooperation. Reproductive BioMedicine Online, 29(1), 3-5. Retrieved from https://doi.org/10.1016/j.rbmo.2014.05.001

7. O’Brien, R., et al. (2021). Exercise Adherence in HIV: The Role of Supervision and Support. HIV Medicine, 22(4), 282-290

FAQ

Why is exercise important for older adults living with HIV?
Exercise is essential for improving physical health, mental well-being, and overall quality of life in older adults living with HIV. It helps manage the long-term effects of the virus and treatment.

What are the key components of an exercise prescription for this population?
Key components include thorough assessments, individualized goals, a combination of aerobic, resistance, and flexibility exercises, structured supervision, and gradual progression in intensity and volume.

How does multidisciplinary collaboration enhance exercise programs?
Multidisciplinary collaboration allows for comprehensive care that addresses the diverse needs of older adults living with HIV, ensuring better communication among healthcare providers and optimizing resources.

What role does pre-exercise health screening play?
Pre-exercise health screening identifies any existing health issues and ensures that exercise programs are safe and tailored to individual needs, which helps in preventing injuries and enhancing adherence.

How can exercise engagement be enhanced?
Exercise engagement can be enhanced through regular supervision by qualified professionals, creating a supportive environment, providing immediate feedback, and fostering a sense of community among participants.