Research consultancy

Research consultancy

The Impact of a 12-Week Aerobic Exercise Program on Immunological, Functional, and Psychological Outcomes in HIV-Positive Clients on ART

Chapter One: Introduction

Since the identification of AIDS in 1981, HIV has remained a major global health challenge, particularly in Uganda, where over 1.5 million people live with the virus. Despite advancements in Antiretroviral Therapy (ART), which has improved life expectancy, PLHIV continue to face complications such as immune suppression, mental health disorders, and treatment side effects (e.g., fatigue, nausea, and reduced functional capacity).

Aerobic exercise has emerged as a promising adjunct therapy, with studies suggesting benefits for immune function (e.g., CD4 count improvement), physical capacity, and mental well-being. However, its integration into clinical practice in Uganda remains limited. This study examines the effects of a 12-week aerobic exercise program on:

1. Immunological measures (CD4 counts, viral load)

2. Functional work capacity (VO₂ max, Duke Activity Status Index)

3. Psychological markers (depression, anxiety, neuroticism, phobia)

By addressing gaps in current HIV management strategies, this research aims to provide evidence-based recommendations for incorporating exercise into holistic care for PLHIV.

Literature Review

Immunological Benefits of Aerobic Exercise

Studies indicate that moderate aerobic exercise enhances immune function in PLHIV, with potential increases in CD4 counts and reduced inflammation. However, findings on viral load remain inconsistent, warranting further investigation.

Functional Work Capacity

HIV and ART side effects often impair physical endurance. Aerobic training has been shown to improve VO₂ max and daily functional capacity, as measured by tools like the Borg RPE Scale and DASI.

Psychological Well-being

Mental health disorders (depression, anxiety, paranoid ideation) are prevalent among PLHIV. Exercise acts as a natural antidepressant, reducing cortisol levels and improving mood through endorphin release. Structured aerobic programs have demonstrated significant reductions in depressive symptoms and neuroticism.

Gaps in Current Practice

Despite global evidence supporting exercise therapy, Uganda lacks standardized guidelines for its implementation in HIV care. This study seeks to bridge that gap by evaluating a tailored 12-week aerobic intervention.

Methodology

Design: Quasi-experimental study
Location: General Military Hospital (GMH) Bombo, Uganda
Participants: 135 HIV-positive adults on ART for ≥12 months (asymptomatic, aged 20+). Exclusions: Opportunistic infections, contraindications to exercise.
Intervention: 12-week aerobic program (walking, cycling, dancing; 3–5 sessions/week).
Measures:

• Immunological: CD4 counts, viral load

• Functional: DASI, VO₂ max estimation

• Psychological: Standardized scales for depression, anxiety, phobia
  Analysis: Paired t-tests (SPSS v20; significance: *p* ≤ 0.05).

Results

• Immunological: Significant CD4 count improvement (*p* < 0.001) in the exercise group vs. controls.

• Functional Capacity: 72.4% of participants showed enhanced endurance (DASI scores).

• Psychological Outcomes:

  • Depression: 86% of exercisers reported symptom reduction vs. 27.5% pre-intervention.

  • Anxiety/Phobia: 80.8% improvement in neuroticism; phobia scores decreased by 42.4%.

Recommendations & Conclusions

1. Clinical Integration: Include exercise scientists in HIV care teams to prescribe tailored regimens.

2. Policy: Uganda’s Ministry of Health should formalize exercise guidelines for PLHIV.

3. Education: Train clinicians on exercise prescription and mental health benefits.

4. Research: Further studies on optimal exercise duration/intensity for long-term adherence.

Conclusion: Aerobic exercise is a low-cost, high-impact intervention that improves immunological, physical, and mental health outcomes in PLHIV. Its adoption could transform HIV management in resource-limited settings like Uganda.