# Exercise as it relates to Disease/Resistance Training & HIV/AIDS

1.1 What is HIV?
Human Immunodeficiency Virus or more commonly known as HIV is a condition of progressive failure and function of the immune system. This infection targets helper T cells, macrophages & dendrites leading to a decline in CD4+ T cell levels. As the infection kills these CD4+ T cells the wall of our immune system fail leaving patients weakened and extremely vulnerable to dangerous infections and diseases including various forms of cancer. HIV is also the precursor to & the cause of Acquired Immunodeficiency Syndrome or AIDS an elevated & more life threatening form of the two immune system viruses.
1.2 How do you get HIV?
HIV/AIDS can be transmitted when a number of bodily fluids enter the blood stream including:
* Blood
* Semen
* Vaginal Secretions
* Breast Milk
* Rectal Secretions
These body fluids must come into contact with a mucous membrane or damaged tissue or be directly injected into your bloodstream (by a needle or syringe) for transmission to possibly occur. Mucous membranes are the soft, moist areas just inside the openings to your body. They can be found inside the rectum, the vagina or the opening of the penis, and the mouth.
1.3 How is HIV Spread?
While there are hundreds of possibilities of spreading HIV, the more commonly documented reasons include:
* Unprotected sexual intercourse
* Mother passing onto child during pregnancy
* Sharing of needle/syringes (commonly drug users but also possible from tattooing and body piercing
* Having multiple sexual partners or sexually transmitted infections brings higher risk of contracting HIV
1.4 Symptoms
Due to the destruction of the body's immune system the symptoms are more general & related to flu-like symptoms including:
* Muscle Wasting (atrophy)
* Headaches
* Rash
* Sore throat
* Fatigue
* Joint & Muscle Pain
1.5 Prevalence
* 33.4 Million people are currently living with HIV/AIDS
* 70% of those infected with HIV/AIDS are living in Africa
* HIV infection is much more common in countries with a low socio-economic living due to the unavailability & unpractised of safe sex

## Resistance Training

2.1 What is it?
Resistance training (also called strength or weight training) refers to the use of resistance during exercise movements in order to force musculature contractions & therefore improve strength, size and function of skeletal muscles.
2.2 Benefits for HIV patients
Due to the severity of the HIV/AIDS infection there is still no existing cure and treatments are constructed towards improving conditions of the patient with the goal of improving the quality of life.
Many studies have concluded that patients that participated in a progressive strength training program experienced:
* Increases in lean body mass (LBM)
* Increase in strength
* Improvements in physical Fitness
Patients with a HIV infection experience high levels of muscle wasting, joint & muscular pain. These symptoms have shown to be decreased greatly with the assistance of a progressive strength training program. Those patients that experienced great amounts of these symptoms reported a great improvement compared to those that had not experienced that level of muscle wasting.
In a study conducted in Brazil on the effects strength training had on elderly HIV infected patients it was concluded that the participants experienced improvements in:
* Strength
* Physical Fitness
* Reduced Skinfolds
* improvement in the CD4+ and CD4+/CD8+ counts in HIV positive elderly patients without significant side effects.
2.3 Recommendations
Evidence based research recommends that the implementation of a progressive load strength training program will benefit patients of HIV/AIDS. Focus should be placed on functionality of the chosen movements and loads should be kept at sub-maximal weights to ensure they can be lifted smoothly. Load should be progressively increasing overtime to ensure progress in strength.

## Further reading

* Resistance exercise training reduces hypertriglyceridemia in HIV-infected men treated with antiviral therapy Kevin E. Yarasheski, Pablo Tebas, Barbara Stanerson, Sherry Claxton, Donna Marin, Kyongtae Bae, Michael Kennedy, Woraphot Tantisiriwat, William G. Powderly Journal of Applied PhysiologyJan 2001,90(1)133-138; http://jap.physiology.org/content/90/1/133
* Facts about HIV/AIDS, Sacramento County Department of Health and Human Services Epidemiology and Disease Control Unit, http://www.dhhs.saccounty.net/PUB/Documents/AZ-Health-Info/PUB_AIDSBrochure.pdf

## Referencing

* 1 2 3 4 US Dept. of Health & Human Services (2014). 'What Is HIV/AIDS?' http://www.aids.gov/hiv-aids-basics/hiv-aids-101/what-is-hiv-aids/index.html
* 1 2 3 4 US Dept. of Health & Human Services (2014). 'How Do You Get HIV/AIDS?' http://www.aids.gov/hiv-aids-basics/hiv-aids-101/how-you-get-hiv-aids/index.html
* ↑ US Dept. of Health & Human Services (2014). 'Global Satistics' http://www.aids.gov/hiv-aids-basics/hiv-aids-101/global-statistics/index.html
* ↑ WHO: World Health Organization, HIV/AIDS: Fact Sheet (2014)http://www.who.int/mediacentre/factsheets/fs360/en/
* ↑ Better Health, Victorian Government. (2014) http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Resistance_training_the_health_benefits
* 1 2 3 Grinspoon S, Corcoran C, Parlman K, Costello M, Rosenthal D, Anderson E, et al. Effects of Testosterone and Progressive Resistance Training in Eugonadal Men with AIDS Wasting: A Randomized, Controlled Trial. Ann Intern Med. 2000;133:348-355. doi:10.7326/0003-4819-133-5-200009050-00010 Retrieved on 30/10/2014 http://annals.org/article.aspx?articleid=713835
* 1 2 3 Roubenoff, R. Wilson, I. (2001) 'Effect of resistance training on self-reported physical functioning in HIV Infection' Medicine and Science in Sports and Exercise 33 no11 N 2001. Retrieved September 30th, 2014. http://www.ufrgs.br/provida/acervo/exercicio_resistido/Effect%20of%20resistance%20training%20on%20self-reported.pdf
* 1 2 Souza, Paula Maria Loiola de, Jacob-Filho, Wilson, Santarém, José Maria, Silva, Alexandre Rodrigues da, Li, Ho Yeh, & Burattini, Marcelo Nascimento. (2008). Progressive resistance training in elderly hiv-positive patients: does it work?. Clinics, 63(5), 619-624. Retrieved September 30, 2014, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000500009&lng=en&tlng=es. 10.1590/S1807-59322008000500009.