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The Effect of a 12-Week Aerobic Exercise Program on Immunological Measures in HIV-Positive Clients on ART

Study Overview

A study conducted in Uganda examined the impact of a 12-week aerobic exercise program on HIV-positive individuals receiving antiretroviral therapy (ART). Participants were divided into a control group (no intervention) and an experimental group (moderate-intensity aerobic exercise). Both groups were assessed using a Physical Activity Readiness Questionnaire (PAR-Q). Key outcomes included immunological markers (CD4 count), functional work capacity, and psychological well-being.

Results showed that aerobic exercise significantly:

• Increased CD4 cell counts (indicating improved immune function).
• Enhanced functional work capacity (measured by VO₂max and perceived exertion).
• Reduced psychological distress (anxiety, depression, and other markers).

The findings suggest that integrating structured aerobic exercise into HIV care could improve quality of life and reduce mortality rates.

Chapter 1: Background and Objectives

Background

HIV, a retrovirus targeting CD4 cells, weakens the immune system over time. Globally, 37.9 million people were living with HIV/AIDS in 2020 (UNAIDS), with sub-Saharan Africa, including Uganda, disproportionately affected. By 2022, Uganda reported 1.5 million people with HIV and high AIDS-related mortality.

While ART has transformed HIV into a manageable chronic condition, challenges persist:

• Side effects (fatigue, metabolic disorders, psychological distress).
• Sedentary lifestyles exacerbating obesity and cardiovascular risks.
• Limited guidance on exercise prescriptions for HIV patients.

Aerobic exercise has demonstrated benefits in:

• Boosting immunity (increased CD4 counts).
• Improving mental health (reducing anxiety/depression).
• Enhancing physical endurance (VO₂max).

Problem Statement

Despite ART’s success, advanced HIV disease remains a concern due to poor clinical outcomes. Exercise could mitigate ART-related complications, but Uganda lacks:

• Standardized exercise protocols for HIV patients.
• Research on exercise’s role in immune function.
• Public awareness (many patients fear exercise worsens HIV).

Objectives

1. Assess the effect of 12-week aerobic exercise on CD4 counts in HIV-positive clients at GMH-Bombo.
2. Evaluate its impact on functional work capacity.
3. Determine its effects on psychological markers (anxiety, depression).

Chapter 2: Literature Review

Key Findings

• ART Benefits & Limitations: HAART improves survival but causes side effects (fatigue, neuropathy).
• Exercise as Therapy: Aerobic exercise enhances immunity, mental health, and functional capacity without adverse effects.
• Immunological Effects: Some studies report increased CD4 counts post-exercise, while others show no change in viral load.
• Functional Capacity: Untrained HIV patients have lower VO₂max than healthy peers, but exercise improves endurance.
• Psychological Benefits: Exercise reduces anxiety/depression, critical given higher mental health risks in PLHIV.

Gaps in Research

• Few studies in Uganda on exercise for HIV patients.
• No clear guidelines on exercise type, intensity, or duration.

Chapter 3: Methodology

Study Design

• Quasi-experimental (non-randomized control group).
• Location: General Military Hospital (GMH) Bombo, Uganda.

Participants

• Inclusion Criteria: Asymptomatic HIV+ adults on ART for ≥12 months.
• Exclusion Criteria: Opportunistic infections, severe symptoms, or contraindications to exercise.
• Sample Size: 135 enrolled (99 analyzed after attrition).

Intervention

• Experimental Group: 12 weeks of moderate-intensity aerobic exercise (brisk walking, cycling, dance).
• Control Group: Standard care (no exercise).

Data Collection

• Immunological: CD4 counts (PIMA analyzer).
• Functional Capacity: Borg RPE scale, Duke Activity Status Index (DASI).
• Psychological: Validated psychosocial tools.

Analysis

• Statistical Tests: Two-sample t-tests (SPSS v20).
• Significance Level: p ≤ 0.05.

Chapter 4: Results

Key Outcomes

1. CD4 Counts:
   • Experimental group: ↑167.8 cells/μL (p < 0.001).
   • Control group: ↓35.6 cells/μL (non-significant).
2. Functional Capacity:
   • Improved VO₂max and reduced perceived exertion post-exercise.
3. Psychological Markers:
   • 58.5% reduction in depression symptoms.
   • Significant anxiety reduction (p = 0.002).

Chapter 5: Conclusions & Recommendations

Conclusions

• Aerobic exercise improves immunity, endurance, and mental health in HIV patients.
• Structured, supervised programs are safe and effective.

Recommendations

1. Policy: Integrate exercise into Uganda’s HIV treatment guidelines.
2. Clinical Practice: Train clinicians in exercise prescription.
3. Patient Education: Promote exercise adherence via counseling.
4. Research: Explore effects on viral load, body composition, and diet interactions.

Significance of the Study

• First Ugandan study on aerobic exercise for HIV+ patients.
• Supports non-pharmacological interventions to enhance ART outcomes.
• Guides future HIV care strategies in low-resource settings.

References

(Included as per original text.)

Key Improvements in Rephrasing:

1. Concise Structure: Organized into clear sections for readability.
2. Simplified Language: Removed redundancy while retaining technical accuracy.
3. Logical Flow: Each section builds on the previous one.
4. Highlighted Key Findings: Bolded critical results for emphasis.
5. Active Voice: E.g., “The study showed” → “Results showed.”